Could 'telehealth' be cure for Ross out-of-hours GP crisis?
PENSIONERS in rural Ross-shire, where a crisis in the out-of-hours GP service is costing up to £8,000 a weekend for locum cover, could soon be switching on their TVs to see their GPs.
Under plans to plug a GP shortfall with technology, Telehealth would give more doctors the ability to communicate with patients from hundreds of miles away via live-link video.
The move, which would be spurred on by a £146million publicly-funded roll-out of Superfast Broadband across 84 per cent of the Highlands and Islands by 2016, has been given a cautious welcome this week.
Extra workload pressures placed on GPs since 2004 has resulted in fewer opting to see patients after 6pm or on the weekends.
The situation is taking its toll on health care budgets and waiting times at accident and emergency departments are also going up as more people bypass NHS24.
Health bosses are in talks to find a long-term fix and Telehealth is being eyed as a solution.
Gill McVicar, NHS Highland’s director of operations for North and West Highland, said new plans being discussed could bring Telehealth into patients’ living rooms allowing them to sit face-to-face on a screen with a doctor who may be based up to 100 miles away.
“The general public is beginning to understand the benefits of being able to do that,” she said.
“Older people are getting so used to Skyping grandchildren that talking on a screen has become second nature to them.
“Many of them complain about the distances they have to travel and the time they have to wait at the clinic. In the future it is entirely possible for them to speak to their doctor through their televisions.”
Changes in 2004 lifted the obligation for GPs to work out-of-hours but placed more emphasis on quality and improvement, massively increasing recording procedures and paperwork.
Mrs McVicar said this led to a lot of doctors saying it was just too much to work nights and weekends as well.
“And that is the right thing to do because we do not want tired professionals that are at risk of making poor decisions,” she said.
Mrs McVicar said one of the consequences of that was the budget for out-of-hours cover had spiralled out of control.
She said the £9.5million annual budget was already £1.4million into the red.
“For Wester Ross for one weekend we can pay £8,000 to cover — however that is not every weekend,” she said.
Mrs McVicar added they have raised the issue of poor broadband connectivity in some areas with the Government and Highlands and Islands Enterprise.
“From an out-of-hours perspective we would never put in a model that we could not deliver,” she said.
Dingwall GP Miles Mack, deputy chairman of the Royal College of GPs in Scotland, said: “One of the problems is we are so busy day-to-day and it is quite dangerous to be doing those out-of-hours sessions and finding ourselves over-tired.
“But another big problem with that is that we have had quite a significant decrease of funds.
“We have discussed that the proportion of NHS funding to GPs has dropped from 9.4 per cent in 2004 to 7.8 per cent in 2012 — and over that time we have seen a huge increase in workload to GPs. “Recruiting GPs to places like Western Lochaber and Applecross is also difficult. It is unsurprising that it is difficult to fill out-of-hours shifts but there are many problems causing that.”
Dr Mack supports the use of Telehealth but said vast areas of the Highlands have poor connectivity.
“And those are exactly the areas that have got staffing problems,” he added.
Isabelle Campbell, Highland councillor for Wester Ross, Strathpeffer and Lochalsh, said lack of broadband in scattered patches was the biggest hurdle in the way.
“There are a lot of communities working on their own trying to get Broadband but there’s still a lot of pockets without it,” she said.