'People will die' warning amidst Gairloch and Aultbea out of hours cover row with NHS Highland
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Worried community leaders have warned NHS Highland “people will die” after plans to downgrade the Out of Hours medical service at the Gairloch and Aultbea Medical Practice were leaked by local doctors.
The proposal would see NHS Highland (NHSH) replace the long-standing GP-led Out of Hours (OOH) service with a nurse-led service from April 2024. NHS bosses claim the proposed new service is “well tested and has proven popular elsewhere in our remote and rural settings.”
But doctors at the practice have warned NHSH officials that the downgraded service would lead to more hospitalisation, more ambulance transits and more bed blocking at the nearest hospital, Raigmore.
In a letter to the health board they said: ”We do not agree with the proposed service change model and note that it has been tried previously without success in other Wester Ross practice areas. We are very much concerned about the impact this will have on our patients.”
The Gairloch and Aultbea practice has provided a doctor-led OOH service since April 2007.
In July 2023, the practice told NHSH they wished to withdraw from its current contract for providing Out of Hours Services, ”because of our frustration with having tried multiple times to get NHSH to engage with us to review our existing OOH contract”.
But instead of negotiating a new contract with the Wester Ross practice so that the GP-led OOH service could continue, NHSH wrote to the practice on January 17 January 2024 to give the doctors notice that they should stop providing OOH services from April 2, 2024.
The new OOH service would be provided by NHSH directly. It will be staffed by nurse practitioners as part of the “Remote and Rural Support Team,” who may not live in the area, instead of local doctors.
In an open letter posted to the practice website the local doctors explained: “In November and December 2023 there was a GP on duty in our practice area for 100% of the time. From April 2024 onwards that figure will reduce to less than 30%.”
A practice spokesperson said there had been little further communication with NHSH since they had received the January letter. They also claim that NHSH officials have gone on to misrepresent the views of the practice doctors to others.
“We are frustrated but unfortunately not surprised at their unwillingness to engage appropriately with us,” they said.
News of the service downgrade has caused consternation among community leaders.
Gairloch Community Council chair Robert Widdows said bluntly: “People will die.
"A nurse practitioner, however good they may be, is not a doctor. Now, apparently they are now considered to be as good as a GP in the middle of the night.”
It is a journey of at least 75 miles to the nearest hospital from Gairloch, he noted.
“If the ambulance has already taken a patient away, what is a nurse practitioner to do? However good they are, they will not necessarily have the skills to deal with a really serious case.”
Widdows' wife, the Reverend Heather Widdows, is a local church minister in Gairloch.
She said: “I note that the latest slogan for NHS Highland is 'Together We Care'.
"It seems that what they really care about is saving money. If they really cared they would not have announced the change at very short notice. What has worked really well for many years will suddenly change.
“In other words, they don't care very much about the people they are there to serve.”
Local MSP Maree Todd said she too was “concerned” about the lack of communication with locals. Scottish Government officials are now set to intervene with the health board on the issue.
“While NHS Highland is certainly facing pressures, the needs of the local community must come first, and we expect NHS Highland to ensure a safe and sustainable service is provided for the local population,” she said.
Responding, a spokesperson for Highland NHS claimed that officials had not in fact served notice on the Gairloch and Aultbea practice, requiring them to end their OOH services.
This apparently contradicts the January letter sent to the practice that said: “Please accept this email as written notice of our intention to make alternative provision for Out of Hours cover for the full Out of hours period from the 2nd of April 2024.”
The statement continued: “The health and social care partnership have proposed the expansion of a model of care that exists elsewhere in the board.
“The Remote and Rural Support Team, is a proposed model of care which was specifically designed for our more remote communities, already covers a number of very remote and rural locations, providing specialist care to communities across Highland.
“It is clear from the communication of recent days that the practice has changed its position and unfortunate that the community has come to learn of this change in this way. The Board has not served notice to the GP practice and we are happy to follow up with them.
“We will engage with the community to discuss this further and we will, through the local community council, agree how this is best achieved.”
