Medical director says system is reliable

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A condition which has kept him in hospital some four weeks later.

But Dr McKellar is convinced the current system is the best one suited for Harris, and also the wider community of Lewis.

“People do look on this system with envy. It works, it’s sustainable, innovative and it is a way to keep people safe, demonstrate quality and it saves lives,” he said.

“With any change in service, quite understandably, comes fear and uncertainty. And it is our job to make sure the service is safe and to reassure people.

“This is a very good system and it is the best to serve Harris. We know it’s safe and we have tested it rigorously. We had a pilot period and we added capacity, we evaluted, re-evaluated and we extended feedback.

“We’ve had three public meetings, been in touch with the Scottish Health Council, spoken to Lewis Ritchie, doing a national review and to the Scottish Ambulance Service to bolster the service.

“So we are convinced this is safe and appropriate.”

In the past North Harris operated with an onsite GP doing out of hours provision but when the configuration of practices changed they were no longer able to provide that service in the same way.

The changes led the NHS Western Isles to roll out a system operating in neighbouring Lewis.

“We had to consider how we could best provide a sustainable service for North Harris and the method we chose was to expand the Lewis service into Harris,” said Dr McKellar.

“The system operates with safeguards built into it and as we have built it up we have listened to feedback and addressed any risks that have arisen thoroughly.

“It s tarts at 6pm with a community nurse who has been on since 4pm and continues until midnight. Then at 8pm until 8am we have another. We have an out of hours GP commencing duty at 6pm and another at 8pm.”

When pressed about the incident involving the elderly gentleman who was rushed to hospital the following day, Dr McKellar insisted it was a matter for NHS-24 and such an incident could have occurred in 2004, when NHS-24 began operation, or any time since.

“We are really keen to hear about individual cases and we have a good mechanisim for that dialogue with NHS-24 where we have monthly meetings,” he continued.

“When cases come up we have the ability to challenge them and ask them specifically about issues, but there is also inevitably lots of sides to every story and I can reassure you this is nothing to do with the changes in North Harris.”

Dr McKellar is adamant that hiring a nurse to operate out of hours is not the answer and could be dangerous to patients.

“The reason we can’t have a community unscheduled care nurse resident in Harris is it would be pulling the wool over people’s eyes,” he explained.

“That nurse could never operate in Harris and it’s not a financial thing, although that has to be considered too. The reason is that clinician would be seeing a maximum of two cases per week and some of those cases would be travelling to Stornoway so it could be a lot less than that.

“There is absolutely no way such a person could keep their skills up. It’s impossible.

“The reason out of hours GP’s can do that is they are working during the day and the out of hours is an addition to their workload.

“You can’t do that with employed staff so there is no way we are going to put someone in that position because what Harris would get is an unsafe service. If we had lots of spare GP’s we could look at putting one in Harris and try and rotate the system to take one to Harris every day for out of hours but even if we could find the people to do it, which we can’t, there would be an argument about a waste of resource.”

Engagement with the local community remains a key priority for NHS Western Isles moving forward says Dr McKellar.

He added: “We are delighted with that engagement and that’s important. We want to keep engaging with the community and see what’s possible and work together constructively.

“If fear is generated unneccesarily and false expectations are raised then it wouldn’t be meaningful engagment. Let’s see what’s possible, see what works, listen to feedback and if we need to improve let’s improve. I consider engaging with the locality planning group as being the most positive way we can engage.”