Implementation of a new model of out-of-hours GP services in Fife began yesterday despite warnings that it is a dangerous compromise. Those in need of urgent but not emergency care overnight and at weekends may be seen at one of three centres, including St Andrews Community Hospital.
The new arrangements were devised after campaigners fought proposals to permanently close the out-of-hours base at St Andrews. The St Andrews Out-of-Hours Group representing local community councils has called for an external review, claiming the new set-up could put patients at risk.
The St Andrews Out-of-Hours Group claims the new model is unsafe and unsustainable following a flawed consultation process. It says nurses would be working extended periods with no GP support on site and the unit would close two hours earlier than agreed on Saturdays. In a statement earlier this year, Dr Angela Anderson, chairman of the St Andrews OOH Group, claimed that the out of hours service in St Andrews was being ‘set up to fail’.
Commenting on the current proposals, Dr Angela Anderson, said: “We have been keen and enthusiastic to get involved with the redesign for St Andrews, but our group feels angry and shut out of any meaningful discussions. We have big concerns. The university contributes £298.3m to the Fife economy, and tourism £600m annually. We feel we have a duty of care to those people and have a big concern about how things are moving forward.”
Fife Health and Social Care Partnership insist the service is safe, flexible and responsive and are mounting a ‘talk before you walk’ campaign – advising patients to contact NHS 24 on 111 first to ensure they are seen in the right place at the right time.
Dr Helen Hellewell, FHSCP Associate Medical Director, said: “We have worked closely with healthcare professionals, staff and our communities and I believe we have developed a model of care that puts safety front and centre, and that it is sustainable now and in the future for the whole of Fife. Calling 111 first, before travelling to one of the centres, will ensure you are seen by the right person and in the right place.” The caller could get an advice call from a GP, nurse or paramedic, an appointment at a centre, or receive a home visit.
Director Nicky Connor added: “Working together with colleagues and communities to design this service together has been key to developing new rotas and ways of working so that Fife has a flexible, safe and responsive service. Our new model will ensure that we can continue to see people in the right place, at the right time and by the right professionals.”
Out-of-hours urgent care is provided after GP surgeries and pharmacies close and could be for chest or urinary tract infections, palliative care at home, minor injuries or a child with a high temperature not reducing with medicine. The new service will be fully operational by July.
Under the new model it will be delivered from St Andrews, Kirkcaldy and Dunfermline, and patients calling 111 will receive either advice over the phone, an appointment at a centre or a home visit from a GP, nurse, paramedic or, in the case of a home visit, a district nurse.
The out-of-hours GP service at Glenrothes Hospital will close permanently.
North East Fife Liberal Democrat MSP Willie Rennie said: “GP out of hours services will return to St. Andrews Hospital thanks to the thousands of people who stood up and spoke out against the closure over the last 18 months. We will need to monitor it closely to make sure it works for local people and is safe but I am delighted that we won the day.”