FLEXIBLE ESTATE
Agile care in a time of lockdown
Simon Dodds MA, MS, FRCS, Alan MacDonald BSc (Hons), Fay Wilson MBChB, FRCGP, and Terry Young PhD, FBCS, describe the sophisticated planning and work that went into the development of a ‘new generation’ drive-through clinic. Piloted in Birmingham during the pandemic, it allowed patients to simply drive in to see a doctor when conventional appointments were hard to get. The team believes that in future the same model can be used for diagnostics, minor procedures, and to support people with a range of long-term conditions.
On 21st October last year, the local ITV news channel, ITV Central News, reported on a new way for patients who would normally visit their doctor’s surgery, or another primary care facility, to get checked out – a ‘drive-through’ clinic in Aston in Birmingham. Andy Street, Lord Mayor of the West Midlands, turned up to cut the ribbon, and this piece of news between COVID waves was positioned as a way to break the deadlock between the Government and GPs over face-to-face appointments. ‘Drive-in’ movies and ‘drive-though’ fast
food have been around for a long time, so what was so special about drive through medicine? Although the launch was low profile, this ambitious clinic in a refurbished warehouse on an industrial estate on Bourne Road, Aston in Birmingham really was radical. Allowing patients to drive straight in to see a doctor is clearly
attractive – no more sitting uncomfortably in a cramped waiting room at the surgery; no more access problems from car to chair to couch to chair to car (to chair to home again) for those with mobility problems, and much better isolation if the patient didn’t know whether or not they had COVID.
Significant daily capacity For once, GPs didn’t have to tell people to stay away if they were contagious. With the capacity to see up to 500 patients a day, the drive-through clinic is a real alternative to traditional surgeries, and with the ability to deploy them within weeks, the NHS now has a new type of agile response in its tool bag.
Simplicity is only skin deep Beneath the elegance of a system that keeps patients safe in their cars with a
nurse, GP, or healthcare assistant right next to them (the concept is being further developed as a ‘24/7’ drive-in service where patients can transfer to a consulting room), lies a rather more complicated story of deep thinking and planning. Or rather, there are several stories that we need to follow through if we are to grasp quite how unique and important this clinic is. There is a piloting story, because the team that succeeded with this had already deployed a rapid assessment centre using pods and tents in a car park next to the Nightingale Hospital at the NEC Birmingham. The team members had used the learning from that project to deliver a slightly more robust version in ‘portacabins’ nearby at Hobmoor Road and Slade Road. There, they learned how to mix patients in cars with arrivals on foot. Most importantly, they had broken the patient pathway into
Figure 1: Drive-through delivery keeps patients and staff isolated from one another, but close enough to provide care.
Figure 2: A simple model to help stakeholders and clients think things through.
April 2022 Health Estate Journal 23
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