Out-of-hours health service “on a journey”

The Knoll hospital, Duns
The Knoll hospital, Duns

Nurses are likely to be key to future out-of-hours (OOH) health care in the Borders and three new members of staff have been added to the team.

When NHS Borders chief executive, Callum Campbell and emergency care service interim clinical lead, Dr Greg Wheelans, met Duns Community Council members earlier this week they admitted that as far as OOH services were concerned they were “on a journey”. And that journey starts from Borders General Hospital for every shift undertaken by the out of hours GPs and the eight nurses.

Mr Campbell stressed that although all OOH nurses and GPs are based at the BGH, the service is co-ordinated from there and staff go out from there. “They start their shift at BGH and after that they could be anywhere,” he said.

“We may go back to nurses in community hospitals and perhaps on a Saturday or Sunday you may be seen by a nurse at community hospitals in the future.”

Lack of success in recruiting GPs willing to work out of hours shifts in the Borders left the service close to collapse by the end of last year and NHS Borders was forced to change the structure of the service and centralise all OOH GPs at the BGH rather than in community hospitals across the region, such as Duns.

Dr Wheelans explained: “We had to change our way of working so decided to move to a centralised model with the help of nurses.

“GPs wouldn’t come to the Borders to work OOH shifts to cover areas like Duns because they were on their own and there was no support.

“One of our biggest assets is the nurses. We have got one of the most amazing teams of OOH nurses and the big advantage we have is they want to stay here and they want to do this.

“Now what was a GP led service supported by nurses, where I see this going is that we will become a nurse led service supported by doctors.”

And Mr Campbell added: “This is not about money. This service is probably going to cost more money.”

Since January they have appointed three more nurses to bring the OOH team up to eight and are working with Napier University to increase the qualification level of the team to enable them to take on more duties.

Public consultation is currently taking place about the NHS Borders future clinical strategy and they want to hear your views on their vision of out of hours services .

Mark Rowley, chair of Cranshaws, Ellemford and Longformacus Community Council, said: “It seems as if you haven’t quite made up your minds whether it’s best to have the service centralised at the BGH or whether to have satellites.”

The response was that for a rural population decentralising the OOH service was the best model, co-ordinated from a central point.