NHS out of hours service to be tested in North Harris

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A new out-of-hours service, involving specialist unscheduled care nurses as the first point of contact for patients, is set to be piloted in North Harris from October 1, 2014.

Over a number of months, NHS Western Isles has been working with local clinicians to consider the potential options for providing safe, appropriate and sustainable medical cover for the patients of North Harris Medical Practice during the periods when the Practice is closed.

This has been a necessary step, as the GPs in North Harris have confirmed that they will no longer be available to cover the out-of-hours service for the patients of North Harris Practice after December 2014. All GPs have the choice of ‘opting out’ of providing out-of-hours services.

Under new proposals, to be tested for a period of three months from October 1, Community Unscheduled Care Nurses (nurses with additional specialist training) will be the first point of contact for patients who need a visit at their place of residence. This is the same model that serves patients across the length and breadth of Lewis. (GPs in North Harris will continue to be available for home visits for the first two-week introductory period of the pilot.)

For the remainder of the pilot, the out-of-hours service for North Harris Medical Practice patients will be covered by Community Unscheduled Care Nurses and GPs based in the out-of-hours centre in Western Isles Hospital in Stornoway.

If, for any reason, a patient requires the presence of a doctor, then there will also be a doctor available to visit the patient at home. All mobile patients will however be asked to attend the dedicated out-of-hours facility in Stornoway, as is the case for all Lewis patients.

GPs in North Harris Medical Practice will continue to provide services to patients during the day, and arrangements for emergency services with the Scottish Ambulance Service remain unchanged.

NHS Western Isles Medical Director, Dr Angus McKellar explained: “There are significant issues in terms of recruitment and retention of medical staff in all remote and rural areas of Scotland, and there are increasing numbers of GPs opting out of providing out-of-hours cover. This means that we need to consider less traditional models of care, as is the case with many other areas of Scotland. This is the reason for looking at advanced nursing roles and strengthening partnerships with Scottish Ambulance Service staff.

“Under the new arrangements, as is the case presently, patients should call NHS24 on 111 in non-emergency situations. The call will be directed to a GP based in Stornoway, who will decide whether the patient needs to be seen by a GP or a specialist Community Unscheduled Care Nurse. The patient will then either be asked to attend the out-of-hours centre in Western Isles Hospital, or they will receive a visit from a nurse or a GP.”

He added: “Our Community Unscheduled Care Nurses are highly trained health professionals with a wealth of experience. The nurses are enthusiastic about providing this service in Harris and I firmly believe that the patients of North Harris Medical Practice will be delighted with the new arrangements, once they have had first-hand experience of the excellent services that these nurses deliver. I consider that this new service has the potential to strengthen and enhance the services provided to Harris patients. In particular, it will enable the delivery of enhanced healthcare provision to patients within their own homes (that would only previously have been available to hospital inpatients) including, for example, the use of IV antibiotics.”

The new service model will be continually assessed during the pilot period and all patients who use the service will be asked for their feedback, so that arrangements can be effectively evaluated after the three-month pilot.

A further public meeting will be arranged in January to allow the sharing of collated patient feedback and to present the results of the evaluation process.