A LACK of GPs working out of hours in the Highlands is forcing health chiefs to remodel the service and introduce “tele-booths” for patients in remote communities.
The booths would replace face-to-face consultations with a remote connection via the internet to a doctor in Inverness.
The proposed number of “booths”, how they would operate and their exact locations have still to be decided. Health officials say a period of consultation is to be carried out to identify where savings can be made.
The NHS Highland board is being warned by senior officials that the out-of-hours service in the region requires a major revamp in a bid to be cost-effective.
Gill McVicar, director of operations for the north and west, described the current set-up as “a patchwork of piecemeal local arrangements which are increasingly difficult to sustain due to staffing models, lack of GPs working in the system, high use of locums and unaffordable costs”.
But the proposal raised concerns with Mary Scanlon, Highland MSP for the Conservatives.
She said: “It has always been the case that one size does not fit all, particularly in the Highlands.
“We all recognise the difficulties in recruiting GPs and the high cost of locums. Nonetheless, I am concerned about these proposals and fear they are too radical.
“They should be put out to wider consultation throughout the Highlands before I would be supporting people going to tele-booths for medical advice.”
She added: “Patients in the Highlands are entitled, despite the geography, to an equality of access similar to those in a major city.”
Miss McVicar argued the expense of locums was hitting other services. She said: “The cost means that other important and urgent developments are not able to be progressed, thus creating an opportunity cost as well as an overspend.
“With changing demographics and the need for more community-based care, this is no longer acceptable.
“At present, there is limited co-operation across boundaries which can lead to one area being extremely busy and staff stretched whilst another has very low activity.
“There are also different pay rates across area boundaries which can lead to quieter areas being more attractive to the workforce than those parts where activity and need is greater.”
She said there was a need for change, with work to be done with various partners, including the Scottish Ambulance Service.
Miss McVicar added: “The board will be asked to agree on the key principles for a new model, providing an out-of-hours service that is safe and more sustainable and affordable.
“These principles include, for example, the provision of tele-booths for use by patients to speak to healthcare professionals, routine weekend surgeries run by peripatetic staff in rural areas, and greater community resilience, such as through first and emergency responders and community health assistants.”
A report is to be presented to the Highland board next week.
A spokesman for NHS Highland stressed the proposals were at a very early stage following the workshop sessions.
He added: “They have agreed to move forward with a development of a remodelled service in which telebooths are an option to be considered.”
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