Urgent Care Centre Hours Confirmed

Bermuda Hospitals Board today confirms that the hours of operating for the Lamb Foggo Urgent Care Centre from Saturday 30 November 2013 will continue to be from 4pm to midnight on weekdays and midday to midnight over the weekends. It will also open should the causeway be closed.

The service had been planned to cease on Friday 29 November, in order for BHB to reduce costs as it is expecting to be in debt by the end of this fiscal year. A directive was announced on Thursday 21 November by Government for the urgent care service to continue, while a more efficient and cost-effective solution is developed.

Urgent care services at the Lamb Foggo facility will continue to provide:
• Treatments for minor injuries and illness
• X-ray diagnostics
• An ambulance can be called if someone required Emergency Department services, but ambulances have never been regularly stationed at the UCC, as the fire service acted as first responders

Activities to close the facility had commenced following the business case going to Cabinet on Tuesday 29 October 2013. Redundancy agreements had been agreed with the two urgent care physicians prior to Thursday 21 November. Emergency nurse and Diagnostic Imaging technician schedules had also been changed. To continue the existing service, BHB had to negotiate physician coverage, as well as re-schedule nursing, admissions and technician staff.

The urgent care centre service is led by a physician, with two nurses, one diagnostic technician and admissions clerk. This team assists people with minor injuries and illnesses. Life threatening injuries and illnesses, such as strokes, head injuries, heart attacks, and broken limbs, and people with serious airway, breathing or circulation problems, require services that have only ever been available at King Edward VII Memorial Hospital (KEMH), such as surgery, specialist consults, full on-site lab, MRI and CT. People with such conditions should go straight to the Emergency Department, or call an ambulance, in order to receive the appropriate level of care.

Background
A decision had been taken by the Board on Tuesday 22 October 2013 to cease the urgent care service at the Lamb Foggo Urgent Care Centre in order to save costs.

The decision was based on the following facts:
• Low useage of service, with an average of 14 people per day
• Patient safety was not at risk. The types of minor illnesses and injuries being dealt with could be seen by community physicians, or the Emergency Department, and BHB could support disaster or emergency services (such as when the causeway closes) without the additional burden of delivering an out of hours urgent care service.
• The service was costly for Bermuda ($422 per visit), adding to increasing costs and rising premiums. Driving greater utilization of the service in order to make the service viable would only increase cost pressures without any improvement in outcome than if patients visited their GP, or the Emergency Department.
• An alternative, lower cost provider could run the urgent care service.
• BHB has a duty to run an efficient and financially sustainable service. BHB is facing debt by the end of the financial year and the urgent care service was losing money for BHB – even the small operational surplus made in 2012/13 would have been wiped out by centralized costs such as insurance, sick and vacation leave cover and management of the operation. BHB is already absorbing a $14m loss for continuing care services, for which it is no longer paid, and has no capacity to absorb the UCC loss.

The business case for ceasing the service was provided to Cabinet on Tuesday 29 October 2013, and the announcement by BHB was made on Thursday 31 October 2013.

The executive summary of the business case was made publicly available on 31 October by BHB, and the original business case for the service was made public by the Minister of Health & Seniors on Thursday 21 November.

The Minister of Health & Seniors announced publicly the directive to continue the service while a more cost-effective solution was developed on Thursday 21 November 2013.

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