Weston General Hospital proposals reviewed at council health scrutiny meeting

Friday 22 April 2022:

 

Proposed changes to some services at Weston General Hospital have been reviewed by councillors at a key meeting this week.

 

The proposals - designed by senior clinicians and other health and care staff - would mean thousands more people receiving their planned care at Weston General Hospital every year.

 

Councillors agreed that the favoured option for change does not constitute a ‘substantial variation’ to services. While a formal public consultation would not be required, the local NHS would still hold a period of engagement on the draft proposals to better understand the public’s views.

 

Public engagement on the proposals is likely to begin early in the summer, with a final decision about any changes taken later this year.  A more detailed timeline will be shared in the near future.

 

Meeting papers of the North Somerset Council Health Overview and Scrutiny Panel are available to view on the North Somerset Council website.


How The NHS Works

Friday 1 April, 2022:

Using the right health and care services at the right time contributes to everyone getting the best possible care. Not everyone who needs NHS assistance has English as their first language, and this can include people who have recently fled conflict in their home country.

A series of leaflets, in many different languages, have been created by an independent humanitarian movement called Doctors of the World. These leaflets include details of how and when to access different NHS services including pharmacy, GP practice, dental, mental health and emergency services.

Many of these leaflets can be downloaded for free below. They are available in languages including Ukrainian, Somali, Polish, and Urdu.

 

https://bnssghealthiertogether.org.uk/documents/how-the-nhs-works/

 


Healthy Weston: Phase 2

14 March 2022: 

Bristol, North Somerset and South Gloucestershire Clinical Commissioning Group and University Hospitals Bristol and Weston have an ambitious vision for Weston General Hospital to lead the country as a successful small hospital delivering truly integrated, safe and high-quality services that meet the specific needs of local people, now and in the future. We will do this by working in new and innovative ways with health and care partners.

We are already on the way to achieving this ambition through the changes implemented at Weston General Hospital a couple of years ago. These have made services safer and more sustainable, particularly for urgent and emergency care, critical care, emergency surgery and acute children’s services. We established much closer working between local GPs and hospital staff and put more focus on providing the services needed by the majority of local people, most of the time.

These improvements were all delivered as part of the initial phase of the Healthy Weston programme. We were clear then that we would need to build on these and explore more opportunities to bring further resilience and stability to Weston General Hospital to fully achieve our ambition. We want to create a centre of excellence in Weston, playing to the unique strengths and further developing the new ways of working already underway.

We set out some information about the opportunities we have in our 2019 public consultation and are now looking in detail at how to take them forward; building on the learning and changes we have made in response to COVID-19.

This second, and final phase of the Healthy Weston programme will focus on securing Weston General Hospital as a thriving hospital at the heart of the community.

We have three areas of focus:

  • Local doctors agree that providing urgent and emergency care services 14 hours a day, seven days a week – as is the current provision – is the right approach for Weston General Hospital. We want people who come to the emergency department at Weston General Hospital to be seen by the right person first time, be treated quickly and have a clear follow-up plan put in place. Most people would be able to go home the same day, while those who require specialist inpatient care will be treated at the most appropriate place - possibly transferring to a larger neighbouring hospital if needed. To enable this, we are looking at whether we can better organise some aspects of emergency care across Weston and North Somerset, Somerset and Bristol as part of a wider network of acute hospitals, each working to their strengths providing efficient, high-quality care for people in the BNSSG catchment area.
  • We want Weston General Hospital, and the place of Weston, to be a centre of excellence for the care of older people, supporting individuals to remain as independent as possible for as long as possible, with different health and social care professionals with specialist expertise working together to deliver joined-up high-quality care. Further developing the award-winning Geriatric Emergency Medicine Service (GEMS) will ensure Weston General Hospital leads the way in providing dynamic, proactive and responsive services helping older people avoid hospital stays where possible and making any necessary hospital admissions as short as possible. An expanded GEMS, working closely with the primary care-led Care Home Hub, would make Weston-super-Mare a national leader in the care of older people.
  • We have the opportunity to increase the amount and type of planned operations and procedures at Weston General Hospital, avoiding travel for local people, offering greater choice and faster treatment from specialist teams for patients from across Weston-super-Mare and North Somerset, Somerset, Bristol and South Gloucestershire. Creating a planned care surgical centre, protected from the competing and often prioritised demands of emergency surgery, will help to address waiting list backlogs. It will also create a centre of excellence for surgical training, attracting new, ambitious health and care staff to the area and providing development opportunities for the existing dedicated and committed workforce at Weston General Hospital.

In addition, we will continue to strengthen how we provide local assessment and treatment of children to support the large number of families living in Weston and the surrounding areas.

There is a positive and exciting future for Weston General Hospital delivering exceptional care and services for our resident communities as well as visitors to the area. This future will be developed by health and care professionals alongside patients, local people and their elected representatives.

The next steps for the programme are to look in more detail at designing the right model of care for Weston General Hospital, and the potential ways we can deliver this model. We will then carefully evaluate suggested options for the future using robust evidence and data to help identify those most likely to bring long-term, sustainable improvements that will see us delivering our ambition for Weston General Hospital.

There will be plenty of opportunity to be involved and we will keep you updated as our work progresses.

On behalf of Bristol, North Somerset and South Gloucestershire Clinical Commissioning Group and University Hospitals Bristol and Weston


Update on health and care services

Thursday 24 February 2022

To everyone in Bristol, North Somerset and South Gloucestershire,

Thank you again for all you continue to do to keep yourselves and each other safe from Covid-19. As the country looks towards the next phase of living with the virus, we wanted to update you on what that means for your local health and care services.

Although all services remain extremely busy, we have thankfully now passed the peak of the Omicron wave. As a result, we are standing down the temporary ‘Nightingale surge facility’ that was set up in the grounds of Bristol’s Southmead hospital earlier this year.

As we work hard to catch-up on operations and appointments delayed during the pandemic, it’s vital that we keep hospitals, care homes, GP surgeries and other healthcare settings as safe as possible. For this reason, we will still ask you to wear face coverings, regularly wash your hands, and – where possible – socially distance when on health and care premises. This will help keep our settings free of infection and protect the most vulnerable from serious illness.

We have introduced a number of new initiatives in response to both the pandemic and the recent high pressure on our services. They include:

  • A new grant scheme of up to £1,200 for people to help their loved ones return home following a hospital stay. The grant can be used to support the costs of shopping, household tasks, meal preparation, cleaning or transport - and is available to individuals, family members, friends, or other advocates of an individual returning from hospital.
  • Expanding our digital ‘pulse oximetry’ services so that more people with Covid-19 can recover from the virus at home, safe in the knowledge that they are being monitored by clinical teams. To date, the service has helped over 900 people in our area. If you or a loved one has tested positive for the virus you may be eligible for this support. Please complete this online survey to find out more. This information is available in multiple languages and British Sign Language (BSL).
  • Expanding our 111 team to include a greater range of clinical professionals.

Please remember as we go into Spring:

  • Vaccination remains the best way to protect yourselves and your loved ones from Covid-19. You can find your nearest clinic via grabajab.net for first, second and booster doses.
  • You should only ever call 999 in the event of a serious or life-threatening emergency. Click or call 111 first for urgent but non-life-threatening conditions, rather than visiting busy emergency departments and minor injuries units. You can also call your GP in the day.
  • Get to know your local pharmacy – they can offer clinical advice, prescribe some treatments, and provide over the counter medicines for a range of minor illnesses, such as coughs, sore throats, tummy trouble and aches and pains. Pharmacies are open throughout the day, evening and on weekends and you can be seen without an appointment.
  • Please show kindness and respect to health and social care staff when you come to see us. Sadly, 2022 continues to bring violence and aggression to our doors. This has a considerable impact on people, as this video from UHBW NHS Foundation Trust and this one from North Bristol NHS Trust both highlight.

Thank you again for helping us to help you. You can find more support including local wellbeing helplines, carers links and mental health specific resources on our local resources page.

On behalf of the Executives in Healthier Together

 


COVID-19 vaccination slots now available near you!

Now is a really great time to get vaccinated for COVID-19, as we welcome in 2022 and start looking forward to the year ahead.

There are currently vaccine slots available right across Bristol, North Somerset and South Gloucestershire, meaning there is a place near you.

Maybe you’ve not had chance during the busy festive period, or you’ve just been weighing it up for a while. But with the festive season behind us, and new year’s resolutions in mind, perhaps now is the right time.

The good news is that it’s never too late, whether it’s a first, second or booster vaccine that’s needed. And appointments are available in a wide range of settings including GP practices, community pharmacies and dedicated vaccination clinics.

To find out more, and select the setting which best suits you, visit www.grabajab.net today. Thank you.


It’s not OK: healthcare staff stand together against unacceptable behaviour

Local NHS health and care organisations are repeating calls for people to be kind and respectful, following a rise in violent, aggressive and abusive behaviour towards staff.

Whilst the majority of patients and visitors to healthcare settings are respectful and appreciative, there has continued to be a worrying rise in abusive behaviour during the pandemic.

Healthcare staff know and appreciate that there will be occasions where patients, due to the nature of their condition or through cognitive impairment, may become confused or stressed in unfamiliar environments; which can lead to challenging behaviour. Staff are offered de-escalation training to help deal with these kinds of instances in an appropriate manner.

However, there are many violent, aggressive and abusive incidents which do not involve such patients and can have a lasting impact on NHS staff who deserve to be able to feel safe when they come to work.

A campaign called ‘It’s not OK’ is under way, which features healthcare staff sharing their experiences and urging the public to respect healthcare staff and remember that they’re people, too, following the rise in incidents.

Lizzy Hooper, deputy matron at Yate’s Minor Injury Unit (MIU) says: “I shouldn’t have to be fearful for my team’s safety, yet this is a large part of what I am facing at the moment. We work very hard to ensure people in our care can be safely assessed and supported with their health care needs. It can be very challenging when individuals expect us to be able to see conditions we are not able to treat; we can only see minor injuries less than two weeks old. Some people visiting the department are reluctant to accept there are more appropriate options available to meet their needs. We would ask people to be kind and understand the pressures that we are all facing in these challenging times.”

Hannah Walker, a sister in the children’s emergency department at the Bristol Royal Hospital for Children which is part of University Hospitals Bristol and Weston NHS Foundation Trust (UHBW), said: “Unfortunately, we have seen a significant increase in the number of incidents of violence and aggression displayed towards staff by members of the public. This is not acceptable. It impacts on how staff feel at work and can also be really challenging for other families to witness. Please remember our staff are people too, please treat us with respect.”

Donna Walker, receptionist for Yate’s Minor Injury Unit (MIU), says, “I can feel quite vulnerable while working at the front desk and not knowing who I may deal with every day, particularly when it is really busy. It can also feel very unsettling and demoralising when trying to help a person, only to be yelled at and sworn at along with negative and quite mean comments made towards me and my colleagues.”

Michaela Winkworth, a call handler for the outpatient appointment centre at UHBW, said: “I absolutely love my job as a call handler and find it very rewarding to help patients. Unfortunately, there have been many occasions when patients call and can be verbally abusive and use abusive language. This can make me feel deflated and drained and can be quite stressful.”

Robyn Clark, practice manager at Kingswood Health Centre, said: “There is enormous pressure on the healthcare system at the moment and surgery staff are doing their best to support and assist patients wherever possible. Sadly the amount of abuse being directed at them is still continuing and I have had to write to more patients regarding unacceptable behaviour in the last six months than in the previous four years. Many reception staff are now leaving their roles as a result, making it even harder for patients to get through and obtain the help they need. We want to reinforce that healthcare staff are people too, and patients should treat staff how they would like to be treated in the same scenario. We are all in this together.”

Dr Katrina Boutin, GP at Old School Surgery in Fishponds, says: “Unfortunately, we are still seeing too many cases where patients become violent and aggressive with our clinical or reception staff, which is extremely distressing for them. Staff in GP surgeries are working harder than ever to see and speak to as many patients as we can in the face of extremely high levels of demand.

“We want to make sure that you see or speak to the person who can best help you with your concerns and that we prioritise those who have the greatest clinical need. We understand that this can be frustrating at times if you have to wait longer than you’d like for an appointment, but aggressive or abusive behaviour makes things even more challenging for us. We would really appreciate your patience and understanding.”

There are a number of measures in place to support healthcare staff when experiencing violent or aggressive behaviour from patients; ranging from warning letters and acceptable behaviour contracts to patients being excluded from the premises and, in some circumstances, involving the police.

NHS staff should be able to carry out their work free from the threat of aggressive or abusive behaviour, while being treated with respect and remembering they are people, too.


Bristol health and care partners urge simple covid precautions to help protect communities

Statement from Bristol COVID-19 Local Engagement Board, Health Protection Advisory Group and Bristol City Partners:

We know that everyone has had to make a sacrifice. Now we are seeing lives and livelihoods are being disrupted once again - the virus is thriving as people gather indoors and the cold weather sets in.

The virus continues to circulate widely in our communities, impacting individuals, families, businesses and some of our most vulnerable communities and, together, we must take action.

We are not in the same place we were last year. Thankfully, due to the successful rollout of the vaccination programme, many more people have a strong layer of protection against becoming severely unwell from the virus.

In Bristol, 77% of people over 16 have had one dose of a vaccine, and 71% of people over 16 have had both doses of a vaccine. However, this does not mean the virus still can’t be passed on to others – many of our younger population, frontline workers and those most vulnerable are still at risk of becoming unwell.

Bristol must prepare for what is likely to be a very challenging winter – for us as individuals and families, but also for our NHS and social care colleagues, our schools, universities and colleges and our local business.

Our frontline NHS and health staff are still under considerable pressure, and we ask that you be patient with staff in hospitals, surgeries or care homes, where pressures are resulting in longer waits – they are doing their best in tough circumstances.

Our businesses and social enterprises are still at risk of closure due to staff shortages.

Over the winter, our health and care systems, workers and individuals are likely to be additionally vulnerable to other cold weather pressures such as flu and winter bugs.

The evidence tells us:

  • Wearing a face covering reduces the chance of infection.
  • Testing identifies positive cases, and people who are positive and have no symptoms.
  • Isolation prevents transmission.
  • Fresh air reduces transmission.
  • Vaccination reduces harm and saves lives.

And as a city, with our neighbours and wider partners, Bristol expects and strongly recommends the adoption of these simple precautionary measures to protect us all:

  • If you are unwell, reduce the spread of infection by recovering at home.
  • If you have symptoms of COVID-19, self-isolate at home and book a PCR test.
  • Make use of the offer of free lateral flow (rapid) testing – uptake in Bristol has been very high which is really positive.
  • Wear a face covering (unless exempt) – in crowded areas like supermarkets and in shops, on public transport and indoor settings.
  • Respect one another’s space – mild illness for you could be very serious for someone else, so please think of others when you’re out and about.
  • Meet outdoors where you are able, or if you’re meeting indoors, make sure to open a window or door to let in blasts of fresh air – this is particularly important when you’re meeting or socialising with people or family members who may be more vulnerable to severe illness.
  • If you are invited for your annual flu jab, or you’re contacted about a COVID-19 booster vaccination, do not delay in booking your appointment.
  • Take additional precautions and consider the risks of visiting elderly people or family members in care homes.
  • We expect and recommend people be kind and empathetic towards one another – we are all in this together, and must support one another through what is likely to be another tough winter.

Thank you.


Chair-designate confirmed for BNSSG Integrated Care System

Jeff Farrar has today (Friday, 15 October) been announced as Chair-designate of the Healthier Together Partnership, the Integrated Care System (ICS) for Bristol, North Somerset and South Gloucestershire (BNSSG).

The appointment follows a nationally run competitive process to secure Chairs for Integrated Care Systems across England, ahead of the bodies becoming statutory from April 2022. All appointments have been recommended by NHS England and Improvement, and approved by the Secretary of State for Health and Social Care.

Jeff has been interim Chair of the Partnership – formed of local organisations, including NHS hospital Trusts, community services, the three local authorities and BNSSG Healthwatch – since April 2021. Prior to this Jeff held the role of Chair for the University Hospitals Bristol and Weston NHS Foundation Trust (UHBW). His career in the public sector includes 35 years with the police service, where he reached the rank of Chief Constable with Gwent Police.

Speaking about his appointment, Jeff said:

‘It’s a real privilege to take up this role.

The response to the pandemic and the strength of the local vaccination roll-out show what can be achieved when we work with our communities as equal partners. In continuing to develop these approaches, we have a great opportunity to improve the health and wellbeing of everyone in Bristol, North Somerset and South Gloucestershire.

We have big ambitions as Healthier Together – to improve people’s health and happiness, provide services that fit in with people’s lives and tackle the inequalities some groups face. Fortunately, we have real strengths to build on - including the deepening partnership between our organisations, a vibrant voluntary and community sector and our incredible health and care workforce.

I’m looking forward to getting started in the new role and working with my colleagues across the health and care system to put people at the heart of all we do.’

Julia Ross and Robert Woolley, Co-Executive Leads for Healthier Together, said:

‘We are delighted to be benefitting from Jeff’s significant experience into the future. He brings a wealth of knowledge and expertise, and a deep commitment to involving citizens in our work.

Jeff’s ability to bring people together, hear different perspectives and lead compassionately has already been a real asset to us as interim Chair, and we look forward to working with him as the ICS progresses to its next exciting phase.’

A Health and Care Bill that will put Integrated Care Systems on a statutory footing (to be comprised of an Integrated Care Board and a wider Integrated Care Partnership) is currently progressing through Parliament. The changes are set to commence from April 2022, and are designed to accelerate the progress made in recent years to better integrate health and care services around people’s needs.

Integrated Care Boards and Integrated Care Partnerships

The Health and Care Bill 2021, which contains a series of measures to formally establish Integrated Care Systems (ICS), is currently at Committee Stage receiving a detailed examination following its second reading.

Assuming the Bill passes, in April 2022, every part of England will be covered by an Integrated Care Board (ICB) and Integrated Care Partnership (ICP). This builds on the existing non-statutory ICSs across England, which for the Bristol, North Somerset and South Gloucester area is currently covered by the Healthier Together partnership. The ICB and ICP will replace the current Clinical Commissioning Group (CCG).

A key element of preparing for legislation to take effect is confirming who would take up senior roles within each ICB, starting with the ICB Chair Designate.

The ICB will take on the NHS commissioning functions of CCGs as well as some of NHS England’s commissioning functions. It will also be accountable for NHS spend and performance within the system. Each area will also have an Integrated Care Partnership or ICP, a joint committee which brings together the ICB and their partner local authorities, and other locally determined representatives (for example from health, social care, public health; and potentially others, such as social care or housing providers). The ICP will develop a strategy to address the health, social care and public health needs of their system, and being a forum to support partnership working.

The ICB and local authorities will have to have regard to ICP strategies when making decisions. Read more about the legislation here.


Local health and care leaders call for public support

Health and care leaders in Bristol, North Somerset and South Gloucestershire are calling on public support to help manage pressures on services, as an increase in non-Covid demand coincides with staffing challenges and continued hospitalisations from the virus.

More than 70 people are being treated for Covid-19 in the area’s hospitals, with a number in intensive care. An increase in people seeking non-Covid support and the recent need for staff to self-isolate has stretched services further – after more than a year of managing the pandemic.

To help cope with these pressures – and ensure that those with the most urgent care needs get the right help first time – people are asked to Help Us Help You, by:

  • Thinking twice about the right service for your needs, using 111 online and pharmacy for minor ailments.
  • Only calling 999 in the event of a serious or life-threatening emergency.
  • Prioritising your second vaccination, taking it up as soon as you are eligible.
  • Supporting your loved ones home from hospital as soon as they are medically ready to be discharged.
  • Being patient with staff in our health and care settings, where pressures are resulting in longer waits.

An increase in urgent care demand has significant knock-on effects in the wider health and care system. Health and care staff - including physiotherapists and community nurses - are being asked to work in different locations to help manage the surge, meaning that people may need to wait longer for routine services and outpatient appointments.

Rigorous infection prevention and control measures remain in place to protect the most vulnerable, meaning there are fewer hospital beds and less space in waiting areas than prior to the pandemic. Elective procedure cancellations are under continuous review, with difficult decisions being taken on a daily basis as the NHS strives to protect as much of people’s planned care as possible.

Dr Peter Brindle, Medical Director at Bristol, North Somerset and South Gloucestershire Clinical Commissioning Group, said:

“We are facing a unique set of pressures this summer which are being felt across all health and social care services. Community case rates of coronavirus remain high in our area, and we have a challenging few weeks ahead of us as non-Covid demand continues to rise.

“The NHS is absolutely here for you, and people shouldn’t hold on to any symptoms they’re concerned about. However, we do need people to use services considerately and think about the best option for their needs before they set off. If you attend our emergency departments with a minor injury or illness, you’ll be redirected to a more appropriate service – so checking your options before you leave the house is going to save a lot of time.

“111 online and pharmacy are great first ports of call for minor ailments, and can offer a range of expert clinical advice to help you get the support you need – including onward referral if necessary.”

Cllr Mike Bell, deputy leader and executive member for health and care at North Somerset Council said:

“With the pressures that we’re seeing currently across the local health and care system it’s vital that we all play our part to make sure that those in greatest need get the right care when they need it. As a council we’re working closely with our NHS and health partners to ensure that patients leaving hospital move on to get the ongoing care they need either at home or in a care home.

“Families are hugely important for anyone being discharged from hospital and can really help by supporting their loved ones home as soon as possible. And we can all help by following the NHS advice, making sure that if we need health or medical advice that we’re using the right service for our needs.”

Chris Sivers, Director for Children, Adults and Health at South Gloucestershire Council, said:

“Due to a number of contributing factors, the entire health and care system is under considerable strain, and we are asking everyone to play their part to help us manage this pressure.

“Local authority social care departments have an important role in ensuring that those who need support when their NHS care ends, receive the right services at the right time, and the care needed for their continued recovery, and wherever possible, continued independence. We support more people in their own homes than in care homes and we work closely with NHS partners to ensure that if people need treatment or more care at home, this is arranged quickly so that people only go into hospital care if that is the right place for their treatment.

“Families can also help ease the pressures by supporting their loved ones home from hospital as soon as they are medically ready to be discharged, ensuring that they contact the right service for their requirements, and by being patient and considerate if they do experience any delays.”

Christina Gray, Director for Communities and Public Health at Bristol City Council, said:

“It’s vital we all remember the virus has not gone away. Our local health services continue to be under immense pressure. This is largely due to the number of people needing treatment as a result of COVID-19, an increase of non-COVID support, tackling the backlog of non-COVID work and staff shortages. Staff shortages are currently impacted by those needing to self-isolate, as well as staff being on leave for a well-deserved break after an incredibly busy 18 months.

“We continue to work closely with health settings and staff at this challenging time. The Bristol City Council Discharge Team is working rigorously to support patients being medically discharged from hospital, to get people home safely and ease the pressure on services. I urge citizens to do their bit to support health staff and ensure people in urgent need of care get the right support, as soon as possible. Please use the right service for your needs and support loved ones home from hospital as soon as they are medically discharged.

“Getting both doses of your COVID-19 vaccine, taking regular lateral flow (rapid) tests and getting a PCR test if you develop symptoms of the virus are all still key actions that will help us drive down COVID-19 rates and recover from the pandemic.

“Thank you to everyone who has been playing their part in helping to keep everyone safe.”

A complete list of local support - including mental health helpline numbers, the HandiApp for parents, and the latest news on available coronavirus vaccination clinics - has been refreshed online to help people make informed decisions about their care. The webpage can be found on our local resources page.


NHS Walk-In Vaccination Clinic Opens at Cabot Circus

Over the next six weeks, people can have their COVID-19 vaccination while they shop at a new Vaccination Clinic at Cabot Circus, BS1 3BX. The NHS Clinic is located on the upper ground floor of Cabot Circus next to Five Guys and Claire’s, and is part of Bristol, North Somerset and South Gloucestershire’s (BNSSG) drive to make it as easy as possible to be vaccinated around work and lifestyle commitments.

The Pfizer clinic is open every Thursday, Friday and Saturday, 11am to 7pm, from 12 August until 2 October. It is open to anyone aged 17 ¾ and over having their first vaccination or their second dose if their first dose was 8 weeks ago. No appointment is needed and full details, alongside information about other local walk-in clinics, can be found at www.grabajab.net.

Dr Tim Whittlestone, Clinical Lead for the BNSSG Vaccination Programme, said: “We are delighted to open this clinic at Cabot Circus. We’re working hard to make it as easy as possible for people in our area to have the COVID-19 vaccination and this fantastic destination in the heart of Bristol’s shopping district, couldn’t be more convenient!

“Throughout the vaccine roll-out, we have challenged ourselves to think differently about how we make the COVID-19 vaccine as accessible as possible for the communities we serve; we’re grateful to the team at Cabot Circus for making this Clinic possible. Cases of COVID-19 in our area remain high. Getting vaccinated is the best way to protect yourself and the people you love from COVID-19.”

An up to date list of all the walk-in clinics in BNSSG along with options for booking a vaccination appointment can be found at www.grabajab.net.