Health board welcomes Scotland-wide out-of-hours review

Written by Scott Campbell.
Published at 10:54 on 30 January 2015.
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NHS Lanarkshire has welcomed the news that the Scottish Government are to undertake national review of primary out-of-hours services – while a consultation is ongoing in the Lanarkshire region with proposals that would drastically shake-up existing services. 

Scottish Health Secretary, Shona Robison MSP announced that a review into national primary out-of-hours services will look at such services can be maintained to their upmost in times of financial challenges, Scotland’s ageing population, and as health and social care services are integrated.

The review comes more than a decade after the 2004 UK GP contract, which transferred responsibility for delivery of out-of-hours primary care services to the management of health boards, while the review will build on the Scottish Government’s 2020 Vision for the NHS.

Health Secretary Shona Robison announced the review, which will be led by Sir Lewis Ritchie, during a visit to Ninewells Hospital’s A&E department.

“Primary care is the cornerstone of the NHS with more than 90 per cent of patient visits starting and finishing in primary care,” Ms Robison announced.

She added: “Out-of-hours services are a crucial component of this and it is now more than 10 years since the current system was created.

“Our NHS is facing different challenges from a decade ago and we need to ensure all parts of the system work as effectively as possible to support an ageing population and more people with more complex, multiple conditions.

“That is why the time is right to review these services to ensure they continue to deliver sustainable, high quality, safe and effective care.

“The review will look at core requirements for services at night and the weekends as well as what roles and skills are needed, and where. This review will be complemented by the new collaborative approach to unscheduled care the Government is adopting, in partnership with the Academy of Royal Colleges, the Royal College of Nursing and other key partners, which I am also announcing today.”

Commenting specifically on the review of out-of-hours primary care, Miles Mack, Chair of the Royal College of General Practitioners, said: "I welcome this out-of-hours primary care review. This will be an important opportunity to see the work GPs do in out-of-hours recognised and allowed to develop in a sustainable way."

The Health Secretary confirmed that the out-of-hours review will consider:

  • Care expected at night and at the weekend
  • Current best practice
  • Ensuring a high quality and safe experience for patients and health professionals
  • Core requirements for service at night and at the weekend, including roles and skills needed
  • Where service delivery of out-of-hours makes sense on a ‘Once for Scotland’ basis, and where local variation is needed
  • Pilots to test new models

The review is expected to provide recommendations by late summer 2015, but its announcement came none too soon for NHS Lanarkshire, who have welcomed the review. 

Calum Campbell, NHS Lanarkshire’s Chief Executive said: “In Lanarkshire we have reached the point where staffing an out of hours service is difficult and unpredictable. This is affecting patients who often have to wait longer to be seen than we would wish.

“In response to this position NHS Lanarkshire has commenced a service review with full stakeholder involvement.

“We are currently consulting on proposals to change the way primary care out of hours services are provided in Lanarkshire in order to ensure that we can offer a safe, high-quality and sustainable service.

“As we move forward with the Lanarkshire out of hours review process, we will ensure that we are aligned with proposals flowing from the national review in a way that strengthens and enhances future primary care out of hours service provision in Lanarkshire.”

Today’s news comes after the Lanarkshire health board announced a consultation into proposals that would alter the Primary Care Out-of-Hours service throughout Lanarkshire, on 6 January.

In a consultation running until 6 April 2015, NHS Lanarkshire is seeking views on two service models: one primary care out-of-hours centre at Douglas Street Community Health Clinic in Hamilton; or two primary care out-of-hours centres one of which would be in Airdrie Community Health Centre and the other in Douglas Street Community Health Clinic, Hamilton.

The consultation follows an extensive review of the Out Of Hours Service with a wide range of stakeholders that has taken place over the past year, with the two models being consulted upon developed with a range of patients, carers and staff who were involved in the review process. 

Accessed through the national NHS24 service 111, the Lanarkshire out-of-hours service is for urgent assessment and treatment at the evenings and weekends when GP practices are closed. The health board, however, has said that the service is facing major challenges – mostly because of a lack of GPs willing to staff the service. 

At present, patients would call the service can get an appointment at one of the out-of-hours centres in Lanarkshire – in any of the emergency departments at Wishaw General, Monklands and Hairmyres Hospitals. The two previous satellite centres at Central Health Centre, Cumbernauld, and Lanark Health Centre, however, have not been open since June 2014 given the current lack of GPs available to work in the service 

The consultation process includes eight open public meetings at a range of venues across Lanarkshire – with the Cumbernauld meeting scheduled to take place at 6:30pm on Tuesday 10 March 2015, in Cumbernauld New Town Hall – while the full consultation document and accompanying survey can be taken online, here:
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