Hotkidz Clinic: pilot scheme for out of hours care of unwell children gets thumbs up

On the day the nation awoke to hear and read about the dreadful blunders that led to the death from sepsis of one-year-old William Mead in Cornwall, Wiltshire Clinical Commissioning Group’s board meeting (January 26) was told about a ground breaking pilot in Salisbury for out of hours care of unwell children by GPs.

The scheme provides health advice and treatment for minor illnesses and injuries and gives parents a local alternative to A&E when their child is ill and their surgery is closed. If necessary, parents are advised to make a same-day appointment at the Salisbury Walk In centre.    

The aim is to provide “A service dedicated to treating children in a safe environment during the out of hours period by local GPs.”  And they have had no problems filling the shifts to staff the pilot.

The pilot runs till the end of March and in its first five weeks 85 children have been seen with only one being referred to hospital:  “It’s so much easier to eye-ball a child.  You can use all the diagnostic templates there are, but eye-balling gets the best results.”

This scheme has already helped reduce the pressure on A&E. Dr Chet Seth, who is a director of Wilcodoc which is running the pilot, and a CCG board member, explained that one advantage of this new Hotkidz Clinic service in keeping children out of hospital emergency departments is financial.

At acute hospitals paediatric assessments in emergency departments are charged to the CCG as an admission.

As with any new services, getting the word out is proving a challenge.  But, with support from the CCG’s communications team, they are making good use of school bag messages, social and traditional media. 

They need more referrals from NHS111.

When asked whether there are plans to replicate this scheme elsewhere in Wiltshire, Simon Burrell who heads the CCG’s north and east locality which includes Marlborough, came back with a quick:  “There are now!”

Given that what is good for Salisbury may not be so applicable in rural areas, this led to a brief discussion about hubs for out of hours services – given that with costs and staffing constraints, it is simply not possible to ‘keep the lights’ on in all surgeries 24/7.

Dr Burrell: “It depends on how far people are willing to travel – or should be expected to travel.”  And Chris Graves of Healthwatch Wiltshire asked: “How do we help them to travel? We need to be building in alternatives to get you where you need to be.”

In rural areas, travel for patients will become a central part of the NHS debate as more and more services are delivered away from the major hospitals and cannot all be ‘close to home’. 

And it comes at a tricky time – as subsidised bus routes are under threat and the RUH hopper bus service is no longer funded by Wiltshire Council.