NHS Highland's decision not to fund a specialist trauma team branded 'perverse’ as political pressure mounts
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POLITICAL pressure is mounting on NHS Highland to guarantee backing for an emergency response service to allow it to continue operating every day.
Since 2016, the Pre-hospital Immediate Care and Trauma (PICT) service has provided specialised care through small teams usually including a doctor, nurse practitioner and specialist paramedic.
Initially operating four days a week, this increased to seven days around 18 months ago, funded largely by the government-sponsored Scottish Trauma Network (STN).
The Scottish Ambulance Service and NHS Highland currently provide smaller shares of funding, but a business case put to the health board for it to provide full funding was turned down last year, despite data showing it reduces pressure on hospital admissions and saves the health board up to £1.3 million a year.
An agreement for STN to continue funding a seven-days-a-week response is due to run out in March, after which the service could revert to just four days.
Despite pledging to review the service NHS Highland has said it would rather invest in the under-staffed emergency department.
That was confirmed by sources who say the team has been informed funding will not be available for a full-time service.
A PICT team member said: “I think it true to say that the team were saddened, and worried about the impact that this will have on the people that we care about – the people of the Highlands who will not receive the care they need when they need it most.”
Professor Phil Wilson, of the University of Aberdeen’s Centre for Rural Health in Inverness, said: “It seems perverse to reduce the operational hours of an obviously excellent service when there has been no proper evaluation yet of its effectiveness both in terms of patient outcomes and in terms of reducing pressure on services elsewhere, for example GPs, emergency departments and hospital admissions,” he said.
“Of course, I understand that the NHS budget is limited and resources need to be allocated rationally in order to get the best ‘impact-per-pound’ but what evidence does the board have that putting money into the emergency department is more cost-effective than funding the PICT team properly?
“Perhaps more importantly, is there any evidence that the board will be able to recruit extra clinicians to work in the emergency department? It has always been difficult to do this.”
Highland politicians are now adding their voices to the debate and piling on the pressure.
Conservative MSP Edward Mountain contacted NHS Highland and has launched a campaign to save the service.
He said: “No guarantees were provided that this vital service would be safe from cuts. Given this unsatisfactory answer, I have reverted back to the chief executive for absolute clarity.
“The many healthcare professionals in the region who have contacted me are shocked and appalled that this truly life-saving service is under review.
“This essential service must be fully retained.”
Labour MSP Rhoda Grant said she has also raised the matter with the health board.
“The staff deserve clarity on their future and I also believe that any initiative that saves lives, time in hospital and cost is worth saving,” she said.
SNP MSP Fergus Ewing said he would pursue the matter with health secretary Humza Yousaf and party colleague Kate Forbes said she had written to NHS Highland seeking clarification around future funding arrangements.
A spokesman for NHS Highland said: “The PICT service is not available on a 24/7 basis but was temporarily able to increase provision from an agreed baseline of four half days per week up to seven half days by accessing funding from the Scottish Trauma Network (STN) on a non-recurring basis.
“It was proposed that recurrent funding for a seven-day PICT could be identified by diverting STN funding away from planned enhancements in emergency medicine services from 2023/24.
“NHS Highland seeks to use this investment to address a substantial shortfall in emergency department (ED) staffing when compared against national standards and we are committed to improving this to benefit all patients requiring urgent care across the region.
“NHS Highland values the role of the PICT service but needs to review how to integrate the PICT service with other trauma and major illness services.”
