GP out-of-hours service in ‘crisis’

NHS Borders, Newstead
NHS Borders, Newstead

The decision to withdraw the Duns-based GP out-of-hours service was made due to a “crisis situation”, according to an NHS Borders manager.

NHS Borders clinical locality manager Ed Witkowski was challenged by members of the public at last week’s Berwickshire Area Forum about why there had been no consultation before the decision was made.

He responded: “It was a crisis situation which is why there was no consultation.”

NHS Borders non-executive director, Pat Alexander, added: “We are looking at how we provide out-of-hours care.

“This is a short-term measure, but we need to look at it across the Borders, along with NHS 24 and accident and emergency.

“Then we will have a clearer idea of what long-term changes we will make.”

Mark Rowley, chairman of Cranshaws, Ellemford and Longformacus Community Council said: “Removal of the out-of-hours service from Duns will bring significant changes with no consultation.”

He added that he had never received so many phone calls on one topic as he had from residents in the community council area when they read in ‘The Berwickshire’ a couple of weeks ago about the changes.

Expanding on his explanation Mr Witkowski added: “There are issues which are obvious changes for local consultation eg major closures, new hospitals etc. In regard to what has happened is that we have had a situation where providing out-of-hours service has become very difficult.

“We have had difficulty in recruiting for the out-of-hours service and this came to a head in the latter part of last year to the extent that the service as designed - we couldn’t provide it, and arrangements have been put in place. It is a recruitment crisis.

“The vast majority of visits out-with normal hours are undertaken by nurses. What will be in place is a hub arrangement based in the accident and emergency department at Borders General Hospital. The calls will be triaged and a clinical view taken.

“There will be no diminution of service.

Mr Rowley stressed how concerned local residents are about the change: “It is a great worry to the locally, chronic sick and it’s going to impact on Duns First Responders. I think you have a crisis on your hands.

“People need reassurance that there are local resources that can get to them in a reasonable time.

“How many people are turning up at minor injuries departments as a result of this?

NHS Borders medical director, Dr Sheena McDonald says: “Our GPs in the Borders are amongst the highest performing across Scotland in relation to the Quality and Outcomes Framework (QOF).

“Over the last 12 months throughout Scotland it has become increasingly difficult to recruit and retain GPs who wish to undertake evening and overnight work when local surgeries are closed. Patient care is our number one priority and NHS Borders has taken steps at an executive and operational level to deal with the challenges that this poses in relation to the out of hours service, and plans are in place to ensure that patients continue to receive appropriate and timely care delivered by suitably qualified clinicians.”

“NHS Borders must evolve the high quality out of hours service that we provide to patients in response to the increasing demands on GPs during their working week.

“Since 2004 care has been co-ordinated from a hub based within the Borders General Hospital and NHS Borders will continue to provide care in this manner with patients triaged to be dealt with in the most appropriate location and by the most appropriate clinician based upon clinical need. Any potential long term changes to the provision of the out of hours service developed by NHS Borders will be subject to the agreed organisational change process which includes public consultation.”