Exclusive A Pulse investigation has highlighted variation across England in the use of acute respiratory infection centers to take the pressure off GPs, with only a few in operation.
In a letter to the ICBs on winter resilience plans in October, NHS England said there should be “active consideration” from ARI centers to support same-day testing in what is likely to be a “very challenging winter”.
But responses to Pulse from ICBs about their plans showed that while most are considering setting up an acute respiratory infection center, many have yet to come to a conclusion.
Only four responding areas already have a center in operation, including South Yorkshire and Staffordshire and Stoke on Trent, Surrey Heartlands and South East London, which said they had “multidisciplinary pathways” to control respiratory infections.
Another six of the 26 responding ICBs will set up respiratory centers, but they are not yet operational, Pulse understands.
The vast majority of respondents said they were still scoping to determine how best to set up acute respiratory services.
Of the three who said they had no plans to implement hubs, some said they had opted for a virtual room model instead.
A support document for local systems for the design of hubs he said they would provide additional capacity to support both primary care and hospitals.
Centers can support same-day assessment and specialist advice, access diagnostics and reduce the burden on GPs, 111, A&E and hospital admissions.
Such an approach would also separate the expected high flow of infectious patients through centers rather than the usual GP waiting rooms and clinics.
The NHS is already experiencing pressures in both primary and secondary care due to high levels of respiratory viruses, including Covid and, in particular, influenza.
The latest figures for the week to December 15 showed an increase in consultations and hospitalizations for influenza, as well as an increase in hospital admissions for Covid-19.
Influenza positivity increased to 20.2% in the last week and the highest positivity was observed in the age group of 5-14 years with 32.9%, data from the Health Security Agency of the United Kingdom.
Dr Laura Mount, a GP in Warrington and clinical director of PCN, said an acute respiratory infection center had not yet been established in her area. Cheshire and Merseyside was one of the regions that did not respond to Pulse’s request for information.
She said: ‘We have been asking for months about the plans for such an increase and we were told there would be no additional resources.
“We were told last week that there are some limited resources now, but the centers need to be set up to cover 250,000 people and therefore cover multiple PCN populations, which actually makes setup quite difficult.”
It has left questions about who will host or manage it in multiple areas of PCN, he said.
‘Also, our neighboring ICS in Manchester started this three weeks ago, so potential replacement staff will already be on contract with them. We are actively working with ICS as PCN to support the start-up.’
Dr Bruce Hughes, a member of Devon LMC’s medical executive team, said: “To the best of my knowledge, the current situation in Devon is that there was talk of setting up a center but nothing yet.”
“The main problem is, of course, that there is no one to integrate them without stripping away an already broken system in general practice.”
Finding staff to work at the centers is a major barrier that other GPs have also told Pulse.
Dr Helen Salisbury, a GP in Oxford and a member of Keep Our NHS Public, said she had not seen any plans for centers in her area. “There is some funding for additional GP/NURSE hours between now and January 6, but as always, it’s hard to find staff to do extra work,” she added.
Dr Grant Ingrams, chairman of the Leicester, Leicestershire and Rutland LMC, said a pediatric respiratory center for the region was launched this week and plans for more centers for adults and children were in progress.
“I hope it’s helpful, but it depends on where they’re located, the capacity and whether we can book them directly,” he said.
Figures from the Office for National Statistics show that Covid rates are rising once again with one in 50 people testing positive. It is the third consecutive week of rate hikes.
Other respiratory illnesses, including influenza, are also putting pressure on services, figures show.
The number of flu patients in the hospital increased by two-thirds in the last week and 50% in intensive care beds.
Status of respiratory centers by ICB area
Respiratory centers in place:
South Yorkshire and Staffordshire
Stoke-on-Trent
surrey heart
South East London
In process of installation:
sussex
Hampshire and Isle of Wight
Cornwall and the Isles of Scilly
Cambridgeshire and Peterborough
the black country
Shropshire, Telford and Wrekin
considering options
North West London
North Central London
Buckinghamshire, Oxfordshire and West Berkshire
Devon
Somersault
Suffolk and North East Essex
Bedfordshire, Luton and Milton Keynes
lincolnshire
Leicester, Leicestershire and Rutland
Greater Manchester
West Yorkshire and Harrogate
Humber and North Yorkshire
discarded
Bristol, North Somerset and South Gloucestershire
North East and North Cumbria
Lancashire and South Cumbria
Note: ICBs not on the list did not respond to Pulse’s request for information
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