THE New Year has brought cheer for Sutherland’s north coast with a breakthrough in the row over out-of-hours medical cover.
NHS Highland is buckling under public pressure and reconsidering its decision to relocate the service outwith the county, it has emerged.
The change of heart follows a “very productive” Christmas meeting between NHS chiefs, local GPs and community council representatives.
Hopes for the way forward are to be outlined at a public meeting in Strathy Hall on Friday, January 12.
But it is understood it involves a four-strong team of associated nurse practitioners (ANPs) supported by local GPs providing the out of hours service in shifts from Melvich Community Care Unit.
Dr Andreas Herfurt, lead GP at the Armadale practice, said: “I am delighted because I think we have a chance to come up with something workable as well as sustainable. This is probably one of the best Christmas presents I have ever had.”
North coast residents were stunned to learn in October that NHS Highland was planning the most far-reaching change to the area’s out-of-hours service since the introduction of the national health service in 1948.
Traditionally local GPs from the Armadale and Tongue medical practices have provided weekday out-of-hours cover to the far-flung, sparsely populated area. At weekends, a locum GP is drafted in to take up the reins – staying in bed and breakfast accommodation in Bettyhill.
But health chiefs suddenly transferred the north coast week-end locum GPs’ base from Bettyhill to Thurso, citing problems with finding B&B accommodation – a claim strongly refuted by local people.
And it was announced that from February 2018 the entire service would be provided by a medic based at the Dunbar Hospital in Wick and four advanced nurse practitioners (ANPs) – who are still to be fully-trained – based at the Caithness General Hospital.
Patients would not have direct access to the service but would have to ring NHS 24.
NHS Highland said the shake-up was being driven by the soaring cost of providing out-of-hours care, the difficulties in recruiting GPs and the low usage of the service in remote and rural areas.
The changes prompted an outcry locally, with residents worried that lives would be put at risk because of the long distances involved – the two parishes of Tongue and Farr are almost as large as Caithness.
It would take a Thurso-based medic 40 minutes to reach Bettyhill; an hour and 10 minutes to reach Tongue and an hour and a half to drive to Melness.
Local councillor Linda Munro was in the vanguard of those fighting against the move. She said NHS Highland was allowing north Sutherland to go into “free-fall”.
Health managers agreed to set up a working group to review the situation in advance of the January 12 meeting, and also to consider an offer from Dr Herfurt to continue providing out of hours cover.
In the meantime it was agreed that status quo should continue and that the weekend locum GP should revert to working out of the area.
The working group met in Farr Edge on Thursday, December 21. In the chair was NHS Highland area manager Michelle Johnston and also present were NHS Highland clinical lead for the out of hours service Dr Antonia Reed as well as statistician Evan Beswick.
Afterwards Dr Herfurt said: “It was a very productive meeting and a robust and friendly discussion.
“We agreed a potential way forward which involves a mix of ANPs and GPs covering out-of-hours in the area, based on the ground – potentially in Melvich where we have the facilities – that is a lot better than running the service from Thurso.
“My Tongue colleagues and my partner Dr Ceri Le Mar and I have agreed to continue as is until April 1, which is when the new contract for Scottish GPs comes into being.”
He added: “The acknowledgement that we have some form of services in the area rather than outwith is a huge leap forward and I am delighted.”
The January 12 meeting takes place in Strathy Hall from 7pm.
An NHS Highland spokesman said: “We had a really constructive meeting before Christmas with doctors and community representatives across the north coast. We reached a shared understanding around some of the challenges, particularly the difficulties in getting staff to work out of hours, problems around skills depletion in low-activity areas, and around on-call working – and around the need to focus our expenditure where there is most benefit to patients.
“However we also reached a shared agreement that we could work together to develop a sensible plan for the North coast, involving a clinician (not necessarily a doctor) stationed further west than Thurso and, crucially, a model which integrates Advanced Nurse Practitioners into daytime practice. The local GPs are willing to continue to provide cover at the current level until April, which gives us some more time to work through this. This is greatly appreciated.”