18 August 2011

Walk-In Centre at the Hospital gets a mixed grade.

| johnboy
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Chief Minister Katy Gallagher has announced the release of ANU’s study of the nurse-led ACT Health Walk-in Centre (WIC).

The report appears to be terrified of making any conclusive statements but seems to go along with the most common criticism of the WIC, that it increases activity on the hospital campus:

Overall it appears most likely that while treating some patients who would otherwise have gone to the ED, the Centre has drawn more patients to the hospital campus and then to the TCH-ED than would otherwise have been the case.

Unlike cranky doctors here at RiotACT we think more people getting treated than would otherwise be the case is probably a good thing.

Ms Gallagher with her usual sunny disposition to these issues has this to say:

“The original aims of the WIC were to fulfil an unmet health care need in the community, better meet projected demand for health services, and develop innovative strategies to recruit and retain a professional multidisciplinary workforce and to relieve pressure on the public hospital system.

“My own view after reading the report has been that the WIC has met three of these aims very well with the only aim in question, being that of relieving pressure on the public hospital system, and in particular the emergency department at the Canberra Hospital.

“The report concluded that it is likely that the overall impact of the WIC is a net increase in emergency department activity. This is suggested to be likely due to the WIC resulting in people going to the Canberra Hospital campus when they may not have otherwise done so. The Government will seek feedback as to whether an alternative location for the Walk-in Centre is appropriate as this has been an area of contention in the past.

Err, hang on. So by relocating the WIC you’re going to take people who need emergency room treatment and make them transit to that treatment?

If you’ve got strong views on this send them in to dcecorporate@act.gov.au over the next six weeks.

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I’ve used the WIC twice so some thoughts:
The first time was a week after it opened, things were still a bit crazy, it was for an ear infection that seemed to go on a little longer than one would expect. In this case the nurse looking at me, felt they needed a second opinion from one of the other nurses on duty. The second time was for having something in my eye. Both of these are the type of things that it was intended for and on both occasions I was very happy with the treatment I received. In the case of the ear infection, they were even able to prescribe some drops to treat it.
So put me down as a twice satisfied “customer”.

johnboy said :

The point is being able to walk in when you need it rather than wait weeks for an appointment.

I’ve never had to wait weeks for an appointment. In fact it’s rare if I can’t get an appointment on the day I call the doctor. The only drawback with my doctors surgery is that they open from 8.30 – 5.30pm Monday to Friday – so not friendly to anyone working and totally useless at the weekend.

On that basis I can see where the WIC might come in handy, although I believe CALMS at the hospital is open from 10am and in Tuggers from 2.30pm – and you will get to see a doctor.

Caractacus Potts1:21 pm 18 Aug 11

According to the review, the average consultation in the WIC costs the government $196. This does not include the fact that it flicks a goodly proportion of its case load to the (even more expensive) emergency department, due to its limited scope of practice or expertise.

Without professing to be an expert in the area, I suspect the government could fund a more effective and efficient service by subsidising the equivalent of 1-2 GPs to provide a bulk-billed service, without increasing the burden on the emergency department. And it would cost half as much. But I imagine that acknowledging that nurses couldn’t do the job as well as doctors would not be politically correct…

err Katy, the purpose of this was to reduce pressure on the Emergency Daprtment. This was said on numerous occasions.

As a non-native Canberran (one of those that comes here for uni and then gets a job) I have used the walk-in centre a few times because of the difficulties/cost involved in seeing a doctor.

Quick and free sick certificates when you have the flu and they are great for the mildly hypochondriac, diagnosed and treated a painful bout of tonsillitis with great results.

johnboy said :

The point is being able to walk in when you need it rather than wait weeks for an appointment.

..and they’re open for longer hours than most GPs (and of course, it’s free).
It’s a tricky one but I agree with JB. If you go to the WIC and they say you are sick enough to go to the ED, then it’s probably a good thing it is nearby? It seems a bit funny to have a service that basically ‘screens’ the level of illness, and when it finds someone in need of a doctor, would like them to go away from the place that treats sick people (the hospital). I suppose it probably depends on how sick they are – will they last a night at home without a doctors treatment/advice? They probably need that level of ‘triage’ so they only recommend serious cases (in their opinion?) go to ED and the rest will be OK till they get to their doc. (BTW, besides ED, they have also been known to give options of CALMS, or the out-of-hours Phillip GP place to people in need of a doc too).
Then of course, that opens up the inevitable issue of litigation if someone is sent away from the hospital (i.e WIC ‘referral’ back to their own GP instead of ED) who then promptly dies at home…. I can see the story in the paper as I type this!
Anyway, I think once people eventually learn what can and can’t be treated there (I agree, it’s a bit confusing at the moment) it should all work a bit better! I think that learning will only come with trial and error, and word of mouth.
The other more sensible option would be to improve resourcing at ED (awesome service once in, long wait times, generally). That way, everyone would win!?

The point is being able to walk in when you need it rather than wait weeks for an appointment.

Saw this post and finally decided to check out where the bloody hell the walk in centre is. Had a quick skim of the FAQ’s and even on my brief read of the information, I would say that with the number of things listed that they DON’T treat that of course the emergency dept. is going to get more traffic. If they can only treat things that are not emergencies and that you would ordinarily go to a doctor for I don’t see the point.

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