Taking the heat off A&E

IPSWICH'S Riverside Clinic opened ten months ago, yet many people in the town still don't know of its existence. Health reporter SARAH GILLETT went to find out how medics are taking the pressure off Ipswich Hospital's busy A&E department.

BUMPS, bruises, broken bones and bites are all in a day's work for Lana Bloom and her colleagues at the Riverside Clinic.

The unit, which opened on April 1 last year, was set up to take the pressure off Ipswich Hospital's increasingly busy accident and emergency department- and has been a huge success so far. With no chasing around for a car park space, and an average waiting time of less than an hour, staff say thousands of patients have been pleasantly surprised with the treatment they received.

Peter Richardson, business development manager for Take Care Now Ltd - the company which run the service, said: “People have said that they are surprised when they get here and everything is so straightforward. One of our visitors said a member of his family has been here recently. He sat down to wait for his appointment but was seen before he even had a chance to open his newspaper. I think that summed it up really - the man had come prepared for a wait and was really surprised when he was seen so quickly.”

Lana, the lead nurse for the unit, added: “We have had lots and lots of thank you letters, people have been really pleased that they've been seen so quickly. Patients have found that because they are in a small pot of clients they get seen more quickly. We see around 80pc of people within an hour.”

The clinic in Landseer Road is designed to deal with minor injuries that do not need to be seen by a hospital consultant - its team of highly-trained nurses can deal with a wide range of ailments that would otherwise mean people ended up in A&E, using valuable hospital time and resources.

Lana said: “We're not trying to replicate anything that A&E does.

“The idea is that we take pressure off the hospital, that people with minor injuries or illnesses come here and don't clog up A&E, so the hospital can concentrate its time on dealing with more serious conditions.

“We have a lot of major roads round here and we need to keep our hospitals ready for action should there be a major incident.”

Staff carry out a variety of minor operations, including suturing (stitching) wounds and removing foreign bodies from wounds, as well as diagnosing and dealing with broken bones.

The unit is one of the most advanced minor injuries units in the country and one of just a handful that has its own X-ray equipment.

When you walk in the door you are met with a bright and airy waiting room. Toys are provided in the corner to help keep children amused, although Lana says they are barely used as the waiting times are so low.

Behind the scenes the unit has several rooms or bays, each dealing with a different type of treatment - a room for minor operations, an X-ray room, and a bay which contains a state-of-the-art slit lamp (the type used by opticians to examine eyes).

There is also an ambulance entrance at one side, although paramedics will only divert to the clinic if the patients is deemed to be 'Category C', which means suffering from minor injuries.

Staff at the centre work closely with Ipswich Hospital and GPs to ensure that patients' treatment is followed through correctly.

While some people may need more advanced treatment at hospital at a later stage, around 98pc of patients are treated without the need for a referral to another health service.

Lana says there have only ever been three people - out of more than 12,000 patients - who have turned up at the clinic and had to be sent straight to hospital because their condition was too serious to be dealt with there.

“Patients actually self select to the right environment pretty well, as long as they are aware of the choice,” she said.

“If they just perceive their GPs as being too busy and think the only alternative is A&E that's what we need to move away from.”

She added: “There has been research done to show that a lot of people will only wait at A&E for an hour before leaving. That tends to be the cut-off point for people, they either wait an hour then leave, or stay there as long as they have to. If this happens it still costs the health service money because these people have to be assessed. Here, we are able to see most people within an hour.”

Since the unit opened, staff have seen a wide range of illnesses and ailments and some are proving more common than others.

Lana said: “Sprains and strains are probably the biggest group of injuries we see. We also get a lot of wounds of varying degrees, from simple to complex - from grazes to tendon injuries.

“Eye injuries are really common. I was surprised by how many of them we see.”

There are also seasonal variations in the work, with the weather affecting the type of things people need treatment for.

“In the summer we were gnat-bite-city,” Lana joked.

“People had bites that were getting infected and we saw a lot of people with allergic reactions.

“It sounds relatively minor but if that increase in work had gone to A&E or to a GP surgery then it would have impacted on everybody else.”

As the centre's first anniversary approaches, word is beginning to spread amongst the local community about the services it can offer, but promoting the clinic is a key priority for staff.

Peter said: “We're having quite a concentrated publicity campaign, because we want people in Ipswich to automatically come here if they have minor injuries.”

Lana agreed: “Getting that in to people's minds is going to be very valuable for people planning services for the town in the future. “In such a growing town we need to make sure there is the capacity for coping with a growing number of minor injuries. We will be close to the new university campus and we're next door to the dockland development.”

Weblink: www.riversideclinic.net

If you have been helped by the Riverside Clinic what did you think of it?

Write to Your Letters, Evening Star, 30 Lower Brook Street, Ipswich, IP4 1AN or e-mail eveningstarletters@eveningstar.co.uk

The Riverside Clinic is one of the first examples in the county of the NHS working with a private company to provide a service. The clinic is run by a company called Take Care Now Ltd (TCN), which is paid to deliver the service by the Suffolk Primary Care Trust.

Although care is not being directly provided by the NHS, treatment is free to patients.

The government wants to see many more of these public private partnerships developed over the coming years, with local NHS trusts taking a step back from services, and managing other providers instead.

The clinic is open from 8am to 10pm and patients can just turn-up. There is no need to call in advance.

Car-parking is free.

The clinic employs 14 nurses and four radiographers - some part-time, some full-time.

The unit can treat problems including:

Cuts, grazes and lacerations

Sprains and strains

Broken bones (fractures)

Bites and stings (including human/animal bites)

Infected wounds

Minor head injuries

Minor eye infections, foreign bodies and scratches

Minor scalds and burns

Bruises

If you are unsure whether your injury is 'minor', call NHS Direct on 0845 4647 for advice.

The Suffolk Doctors on Call telephone operators, who help to direct people to GPs out of hours, still work from the first floor of the Riverside building.

Bryony Rudkin and her family have used the clinic twice, and received phone advice on another occasion.

The Suffolk county councillor said: “The first time we used it was in September when I burnt my arm on the cooker. I tried the kind of first aid you can do at home but I realised pretty quickly it was going to need more than that.

“I was worried it might scar and wanted to get someone else to have a look at it.

“The staff were great, they didn't make me feel like I'd gone for nothing and they were really helpful.”

Mrs Rudkin's arm was treated with a cold compress before being bandaged up and it has now healed completely, leaving no scarring.

The family also used the centre again in December when Mrs Rudkin's nine-year-old son Stan injured his knee at school. She said: “He twisted his knee and the teachers were concerned about it so my husband took him to the clinic.

“They were seen very quickly and he was given pain relief but didn't need any further treatment.”

They also received advice earlier in the year when her other son Finn, 11, broke his toe.

Mrs Rudkin, 43, of Corder Road said: “It was in the summer before they had the x-ray equipment so they advised me to take him straight to hospital.

“Had they had the equipment then I would have been happy to take him there.

“It's great for picking up on all of the little things - like mum burning her arm on the cooker or kids falling over in the playground - which need that bit of extra treatment but don't really necessitate going to hospital.”