AS NHS Borders continues with its plans to reshape health services in the region to meet future demand, specialist consultant clinics held in communities across the region are the latest service to come under the microscope.
The health authority has confirmed that they are in the early stages of considering whether to stop consultant visits to towns such as Eyemouth and Duns and instead have all patients travel to the Borders General Hospital for out-patient appointments.
News of the review was leaked by an insider who said: “To save money, they are planning to stop the consultants travelling to Peebles, Hawick, Eyemouth etc, which means all the patients, including the elderly, will have to travel to the BGH.”
Calum Campbell, NHS Borders chief executive, said: “As part of the ongoing review of all our services, we are looking at how we can maximise the use of our clinicians’ time.
“Many of our consultants and clinic staff spend a significant proportion of their time travelling to peripheral clinics around the Borders. Many of these clinics are under utilised and some have very high levels of patients failing to attend for their appointments. This obviously means clinicians are wasting time which could be spent seeing patients elsewhere.
“It is also the case that many patients, having seen the consultant in a peripheral clinic, will still have to travel to the BGH for the diagnostic tests they require.
“The one stop shop approach we can offer at the BGH will mean patients have fewer appointments and, hopefully, a faster diagnosis and treatment.
“The review aims to identify those clinics to maximise the use of clinical time and reduce duplication for patients. By working more efficiently, we can improve the quality of our services and ensure we can sustain them into the future.”
Their Local Workforce Plan 2010-11 makes it clear that there are still many more changes to come regarding health service delivery in the region, and moves such as the closure of Coldstream and Jedburgh Cottage Hospitals were just the start of the process.
The plan states: “For some conditions, patients will have to travel further. More complex paediatric surgery and vascular surgery are current examples of where Borders patients currently do have to travel further for care and treatment.
“In future, the number of conditions or specialties requiring greater distances to be travelled may increase – such as with the rise in sub-specialisation – but off-setting that will be the trend towards more day case surgery and care within health centres and by non-invasive means such as drug treatment. It may also be possible for certain key services to be expanded locally.
“We need to ensure that across the area that we have a range of facilities that are truly ‘fit for purpose’ and we operate services that are modern, flexible and responsive.
“The changes we have made in recent years in Jedburgh and Coldstream have signalled a willingness to rethink the pattern of service delivery. We need to ensure similar level of review and scrutiny is applied to our other health care facilities.
“There needs to be further thought given to how we can achieve a more efficient concentration of high quality services in more modern facilities and a more co-ordinated networking with acute services, whilst minimising the impact on access.”
The NHS Borders Local Delivery Plan 2011-12 also gives an insight into what the future might hold although there do appear to be some contradictions.
The delivery plan says: “With a presumption against centralisation, ‘Better Health, Better Care’ makes a pledge to bring services closer to patients’ homes – taking services to them rather than them requiring to go to health services.
“Fundamental to this is: a transformation in the way the NHS works, from an acute, hospital-driven service to one that is community-based; a focus on meeting the challenges of an ageing population and the rising incidence of long-term conditions; a concentration on preventing ill-health by equipping the health service to encourage and secure improvements in health; a drive to treat people faster and closer to home; a determination to develop services that are proactive, modern, safe and embedded in communities, or as close to home as possible.