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Gairloch out of hours health care shake-up 'a done deal', Wester Ross critics fear

By Hector MacKenzie

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Gairloch Health Centre.
Gairloch Health Centre.

NHS Highland officials faced a deluge of criticism from locals in a Wester Ross community over a lack of detail about a cost-saving plan that could see local doctors involvement in the area's out of hours health services cut completely.

When news of the service change was first leaked by local GPs, community council chairman Bob Widdows told the Ross-shire Journal he feared that “people would die” because of the change.

Local doctors, who have been involved in the Out of Hours service for nearly 20 years, also warned they were concerned about the impact it would have on their patients.


At a March 11 showdown, community council meeting attended by doctors from the Gairloch and Aultbea Practice, local residents, and NHS Highland (NHSH) managers, health board officials faced criticism for failing to keep locals informed about the planned service changes.

At the meeting one community council member branded the new service roll-out as “a shambles”. NHSH officials at the meeting were unable to confirm when an official announcement would be made about the service and would not be drawn on claims inaccurate information had been sent out by health board officials prior to the meeting.

Locals were told the health board had decided to implement an advanced nurse practioner-led out of hours service in the area as long ago as August 2023. Papers show that managers hope the cash-strapped health board can save £124,000 per year by moving away from model led by local GPs. .

How we first reported the issue earlier this month.
How we first reported the issue earlier this month.

In response to fears from locals, NHSH area manager Gavin Sell insisted that the rural support team (RST) model, which is led by advanced nurse practitioners, could provide virtually the same level of service as a GP-led one, and that it would not lead to additional referrals to hospital.

“There is actually no evidence that using the RST increases conveyances to hospital” he said, “So we can categorically state that there is absolutely no evidence for that in all the data that we’ve got.”

But he also admitted for the first time that they had recruited staff before telling locals about the decision to change the service or apparently considering a “counter proposal” from local GPs that could have seen the continuing involvement of the local medical practice in the out of hours service.

This prompted a number of people at the meeting to conclude the change was a “done deal”.

Local GPs said that the community council meeting was the first time they had had a chance to talk to NHSH managers directly. To date they said they had not been provided with information on where the new staff would be based, how they will handle calls or how clinical handovers will be managed.

Gavin Sell: No evidence new model increases referrals to hospital.
Gavin Sell: No evidence new model increases referrals to hospital.

Only after the meeting was it confirmed to Mr Widdows that the new service would be based outwith the practice area some 40 minutes' drive and 25 miles north from Gairloch.

In a follow-up email sent to the community council, Catherine Shaw, lead advanced practitioner remote and rural support team west at NHSH, admitted: “Ideally we would have wanted something more central so we will be keeping our ear to the ground in the hope that something comes up.”

Dr Kirsty Vickerstaff, one of the doctors at the local GP practice said that it appeared that there was now little opportunity for local doctors or residents to argue for a different out of hours service.

Bob Widdows: 'People will die' warning.
Bob Widdows: 'People will die' warning.

“We think it is a done deal. We still have some concerns about the implementation and the logistics of that done deal. We have some considerable concerns about the way the thing was communicated, both to us and more importantly to the wider community.”

The new advanced nurse practitioner service is due to take over the out of hours service in April 2024.

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