Get creative
I read with a heavy heart of the plight of people who had to wait up to 80 hours for care over the festive period.
Before 2004 GPS were responsible for out-of-hours cover for their patients. Every year I was on call during the festive period – not something to look forward to, as it consisted of 24-hour spells on duty, with often a relentless numbers of calls. This system, however, greatly reduced the numbers of patients unnecessarily having to go to A&E departments, often by ambulance. It would be inappropriate to ask anyone to return to work in such a system – but there are alternative solutions.
The government and Health Boards have made things worse in recent years by shutting down services in Primary Care and closing too many beds – including in community hospitals, thus reducing the opportunity to care for patients locally.
In my own town, the community hospital casualty department was closed down in March 2020 “because of Covid” and has never properly reopened. That situation was repeated across Grampian. Currently, after much campaigning by the town, including by our Councillor and MP, the department is now open for three afternoons a week “if we have the staff”. We are told the main issue is funding – but the unit was funded previously, so money has been removed.
While I was working as a general practitioner the community hospital casualty units across Grampian were being used to look after patients with a wide range of problems, something we were further developing. They were supported by telemedicine links to A&E in Aberdeen. They had equipment for blood tests and ECGS and, during the day, X-ray and ultrasound.
A&E units in major acute hospitals are always going to be busy, but we need to provide patients with alternative ways to access urgent care out of hours. Part of the answer lies in having a network of locally based and well resourced primary care centres, largely using existing premises, where patients can be seen with minor injuries and the range of acute illnesses normally dealt with by GPS. In rural areas community hospitals provide the ideal focus for out of hours emergency care – including, for suitable patients, inpatient care. They should be supported and opened, not closed, regarded only as a great source of “savings”.
(Dr) Robert W Liddell
Turriff, Aberdeenshire