Calls to re-open St Mark's Hospital walk-in centre rejected by clinicians as they back new model

Campaigners have been calling for the re-opening of the St Mark’s Walk-in centre since the popular minor injuries service closed during the COVID-19 pandemic.

But primary care staff believe returning to this would have an adverse impact, particularly on staffing, and the new system is a significant improvement.

It is Friday morning at St Mark’s Hospital and medics are busy seeing patients at the Urgent Primary Care Service, which came into operation in 2023.

In 2020, the minor injuries walk-in centre was re-purposed into a ‘hot site’, where patients who had COVID-19 or were suspected of having the virus could be assessed.

It then became a COVID-19 recovery site and later evolved into the Urgent Primary Care Service.

Despite 370 appointments being available at the former walk-in service each week, only 49 per cent of these were used, Dr Amandeep Dosanjh, a GP at The Cedars Surgery and clinical director at Maidenhead Primary Care Network (MPCN), said.

“It was a walk-in centre, so patients could just pitch up.

“But actually, what happened was it was 49 per cent utilised. There were lots of patients who were not from this area using the site because anyone could come from anywhere,” Dr Dosanjh said. “There were also things that were not suitable.

“There are very specific criteria about what is safe to be seen on a site that doesn’t have a full A&E service.”

The walk-in centre was staffed only by emergency nurse practitioners (ENPs) with no GPs based at the service. Dr Dosanjh explained: “If you had chest pain, if you’d had a seizure, there are certain things that are not suitable to be seen here.

“So that’s why there was a turnover of patients to A&E, because people were turning up here and it wasn’t the right place for them.”

The system now sees patients call their GP practice, and the reception team will ask questions to establish whether the surgery, St Mark’s or a pharmacy is best suited to provide the care needed.

Appointments at the Urgent Primary Care Service have now risen to 854 per week, according to Suzy Simmons, operations manager for primary care at East Berkshire Primary Care Out of Hours, which runs the facility.

Between 92 and 97 per cent of these appointments are used.

The opening hours have also been extended, and there are a wide range of practitioners available.

This includes ENPs, advanced nurse practitioners, GPs, musculoskeletal (MSK) clinicians, practice nurses and phlebotomists.

In recent years, a former storeroom area at the site has also been transformed to deliver new consultation rooms for the Urgent Primary Care Service.

“There’s a wide variety of things that can be done at this site and it allows us to cater for what is going on in the community,” continued Dr Dosanjh.

“We work together in a much more co-ordinated way now, which means that if you’re a patient, you’re getting seen by the right person, in the right place, at the right time.

“Rather than going somewhere just because you want it, but actually it’s not really equipped for what you need,” .

She added it is ‘different’ and ‘people find that hard’, but the response has been ‘really positive’ for the Urgent Primary Care Service.

Over the years, the decision to close the walk-in has been criticised by residents and Maidenhead’s MP Josh Reynolds, who is campaigning for it to be reinstated.

Dr Dosanjh said: “I think everybody has the freedom to voice their opinion and actually hearing those opinions helps us to understand their thoughts.

“People will have had really positive, nostalgic experiences of the walk-in centre.

“We haven’t lost anything. It’s evolved to a better service that’s fit for modern day healthcare.

“We’d encourage more people to engage with us and understand what the service is. I think also, it takes time for people to start to understand that the service is new and what’s changed.

“It’s a much better, safer service, with more utilisation, more availability of appointments for our community, and it also is a service that is flexible.”

Dr Dosanjh explained that if the site were to return to being a walk-in centre, ‘a significant amount of staffing would have to be spent on the triaging’.

She added: “Previously, you would come into the walk-in centre and be seen, but as we said, it’s not always safe because it’s not always the right patients that come to the right place.

“So, what would have to happen now, is you would have to be triaged and then you would have to be monitored until you’re seen, even if it was that you’re not quite at the right place, and that takes a significant amount of staffing.

“To do that we would have to take away from the appointments that are currently on offer.

“So, it’s better we get you to the right place in the first place than have you here and waiting.”