GP shortages and soaring costs hamper Highland out of hours care
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OUT-of-hours health services in the Highlands are becoming increasingly difficult to sustain due to GP shortages and unaffordable costs, officials admit.
Efforts are now being made to find alternative ways to deal with patients requiring help in the evenings and weekends.
These could include greater use of community First Responder volunteers and providing “telebooths” in which people could detail their symptoms via a computer screen to a doctor sitting at a hospital miles away.
The scale of the problem will be spelled out to NHS Highland members on Tuesday.
A report by operations director Gill McVicar describes the current service as “a patchwork of piecemeal local arrangements which are increasingly difficult to sustain due to staffing models, lack of GPs, high use of locums and unaffordable costs".
It reveals that locum GPs can cost the board up to £180-an-hour and that it is becoming increasingly difficult to find salaried GPs willing to work out of hours.
Last night Conservative MSP Mary Scanlon expressed concern about plans to ask First Responders to play a greater role.
“There is a place for them but they should complement rather than replace NHS doctors,” she said. “They shouldn’t be a substitute. I would want to know what kind of consultation is being done with patients and patient groups and GPs. Patients are still entitled to an NHS service at all times and regardless of their rurality.”
In her report, Ms McVicar says the current system dates back to 2004 and was “put in place very quickly” to allow GPs to end out of hours care.
Waiting times at accident and emergency departments are rising as more people bypass NHS24 and head straight to hospital. The situation is also taking its toll on budgets, with locum doctors costing up to £8000 a weekend in some places. A GP covering a weekend overnight shift in Inverness on double time may receive £156 per hour.
NHS Highland’s £10.5 million out-of-hours budget is predicted to be more than £1 million in the red by the end of February.
“We have to ensure that we produce a service which is sustainable and safe and we are not going to do anything which would endanger any patient,” said a health board spokesman. “We are going to deliver a service which is fit for the 21st century.”
It is expected a detailed plan for the new out of hours service will be ready in June.
