DORSET’S urgent care service is continuing to struggle to fill key shifts – putting it under pressure to meet demand.

Health commissioners say they are hoping for improvements when the South Western Ambulance Service withdraws from the partnership later in the year.

Planning is underway, with a target date of April, to transfer the ambulance service urgent care role to a partnership led by the Dorset HealthCare University Foundation Trust.

The ambulance service has been running the 24/7 call service and clinical assessment team for urgent care since last April, but says it is no longer able to do so.

These services are now expected to be brought ‘in house’ by the Dorset HealthCare University Foundation Trust, and its partners. The change will also mean a switch to a new IT system, if it happens.

Senior managers say they are working hard to make sure that the changes will not affect services to the public. The Dorset Clinical Commissioning Group says it will not allow the change to happen until it has been assured of a seamless transition from one service to the other.

The Dorset Integrated Urgent Care Service came into being in April last year, delivered by Dorset HealthCare University Foundation Trust in partnership with the Dorset County Hospital and Bournemouth and Poole hospitals, GPs and, the regional ambulance service.

It provides 24/7 calls to the 111 service, primary care out of hours, improved access to GPs, night nursing and prison health. It was designed to take pressure off the 999 emergency service.

Dorset Council’s health scrutiny committee heard that the contract has been ‘challenging’ with the ambulance trust having difficulty filling shifts for call handlers, clinical supervisors and clinical assessment supervisors – with particular problems at weekends.

The decision of the ambulance service to withdraw will mean investigating new staffing arrangements and a change in the urgent care IT system, which councillors were told had the potential for further disruption to services, although at least one councillor believes it will be better than the IT used by the ambulance service.

Sue Sutton, programme director for urgent and emergency care at the Dorset Clinical Commissioning Group, which contracts and oversees services, told councillors: “We have had teething problems in the first six months and would expect to see improvements, but we are still being challenged and we have work to do with the provider.”

She said that steps were being taken by the Dorset HealthCare University Foundation Trust as the lead provider to improve recruiting. A long-term programme was also being developed to attract additional staff.

“Between now and April we need to ensure there is no detrimental effects from any of the changes,” she told the committee.

Weymouth councillor and local GP Jon Orrell said he was pleased the IT platform was being changed to one which had been developed by GPs and clinicians, rather than the one the ambulance service had been using, which he said was created by IT professionals and ‘widely hated’ by those who use it.

Cllr Andrew Kirby said he hoped that an in-house call centre could be developed in Dorset rather than use existing centres in Exeter or Bristol, which he said would make best use of local knowledge and expertise.

Louise Bates, from Dorset Healthwatch, said the watchdog had noticed an increasing number of calls about concerns with the 111 service and welcomed the action being taken to prepare for the changes.

When the ambulance service announced it would be ending its contract, in July last year, it said that despite being given a ‘good’ CQC rating for NHS 111 in 2018, “the service has struggled to maintain the staffing levels needed to operate this Dorset-based service alongside the 999 emergency services operated by SWASFT across the South West. In particular, resilience is an issue as unlike many other providers of NHS 111, SWASFT does not have other call centres or 111 services to share the call queue or fall back to in times of extremis.”

Speaking after the council meeting Sue Sutton, the programme director for urgent and emergency care at the Dorset Clinical Commissioning Group, said that work was ongoing to prepare for the end of the ambulance service involvement.

“The exit has not happened yet, as a process is underway between Dorset HealthCare and the CCG to determine the best provider. Dorset HealthCare have expressed their intention to provide this themselves and they are currently going through a process with the CCG to ensure they have the necessary skills, staff and infrastructure in place to provide a safe, high quality and effective service.

“There is a plan in development to recruit, train and retain additional staff to reach an optimum level.

“The CCG and Dorset HealthCare are working together to ensure a safe and seamless transfer to the new provider, without any interruption for patients,” she said.