Changes at health centre (Harold Massie)

In August and September 2013 the Shetland Public Partnership Forum (PPF) carried out a survey among patients of the Lerwick Health Centre to establish the cause of much concern over the service being provided.

An amazing 908 people responded to the survey and the message was clear, 78 per cent were unhappy with the appointment system and 73 per cent were unhappy with the walk-in clinic.

The PPF raised four cases for change: the appointment of a dedicated practice manager; better team working; improvements in the amenities; and surgeries outside of normal office hours.

There have been improvements to amenities within the centre which are ongoing and two issues are outstanding: practice manager and the out-of-hours service, both of which are still being pursued.

The better team working case has resulted in two main initiatives, firstly as from last autumn health care assistants have been reorganised to provide more responsive assistance to the general practitioners (GPs). Specifically this has meant that when blood samples have to be taken the patient can have this done straight away rather than having to make a separate appointment.

The second change resulting from this case comes into effect from Monday. As from this date all patients with an acute (short-term) illness will be given an appointment with an advanced nurse practitioner (ANP).

Also from this date there will no longer be any walk-in clinics at the Lerwick Health Centre. Anyone phoning the surgery and needing to be seen on that day will be given an appointment with an advanced nurse practitioner.

There are four new ANPs joining Joan Sandison who has been providing an advanced nursing service for many years. Together they will be able to see up to 100 patients each day which should cope with the number of patients needing seen without them having to wait for hours.

The Public Partnership Forum has worked with the GPs, staff and management at both the Lerwick Health Centre and more widely across NHS Shetland to bring about this change.

This is a major change to the way healthcare is delivered in Lerwick and we urge patients to give the new service their support. Inevitably it will take a little time for the new appointment system and the ANPs to settle in, please be patient.

The GPs have not gone away. There will always be at least one doctor in the health centre whenever there are ANPs taking clinics. The ANPs work under very strict guidelines and should the initial assessment of a patient indicate that a doctor needs to be consulted there will be one immediately available to do so.

If a doctor is called in to see a patient with an ANP the doctor can give guidance to the ANP or even take over the consultation. General practitioners will continue to be available for any patient who needs a home visit and for treating patients who have complex or chronic health needs.

The Public Partnership Forum wishes all the staff at the Lerwick Health Centre much success as they undertake this new way of working and we welcome the new advanced nurse practitioners.

Harold Massie
Public Partnership Forum
South Ustaness,
South Whiteness.


Add Your Comment
  • Paul Smith

    • March 24th, 2015 18:53

    Fantastic news. It about time something changed. The ANPs will have my 100% support

  • Rachel Buchan

    • March 24th, 2015 23:12

    Wow, at least one doctor in the health centre when ANP’s are taking clinics. So that means two doctors – yeah that’s gonna be adequate for the 8 0r 9 thousand patients that this health centre has on it’s books……

    • Harold Massie

      • March 25th, 2015 10:14

      The point is Rachel that 80% to 90% of the reasons why people visit their GP can be fully dealt with by the ANPs so only a small number cases will need the GP to be called in. This frees up the GPs to be available for any patient who needs a home visit and to focus on treating those patients who have complex or chronic health needs (such as Heart Disease, Chronic Obstructive Pulmonary Disease).

      • i r selbie

        • March 29th, 2015 15:03

        the idea is good but doesn’t work in reality, they tried it before and my wife
        and I have chronic COPD and they tried to fob us of with nurses and we had to
        fight for an appointment with the GP who knows our case history. even some
        GPs leave much to be desired in their lack of knowledge of COPD diseases. if Mr Massie you and your panel want personal and family NHS disasters we will
        gladly enlighten you.

      • Johan Adamson

        • March 30th, 2015 10:40

        I think this is good, but I think continuity for the patient is a worry. It seemed to be a factor in the legal case in the recent past – the patient had seen all different doctors and that had played a part in what went wrong. It is certainly an advantage to see your own GP for long term ailments.

  • Ian R Selbie

    • March 30th, 2015 21:28

    first day of the “new” regime at the health centre and the phones still tell you about the walk in clinic, as someone with terminal COPD I asked for an appointment with the Dr who I deal with, the one who said on the radio it would be patients like me who would find it easier to get a GP appointment but when I called today I was told that I had to see a nurse first who would decide if I needed to see a GP, does that mean I have to wait for a GP appointment which may be weeks later and too late, if the GP is in consultation the time that I see the nurse will my GP leave that patient to see me ?, I think not. the walk in clinic was a better idea if those with colds/ flu went to the chemist or just stayed in bed.

  • paul smith

    • April 3rd, 2015 15:48

    I have used the new service and i think its fantastic. I do take your point in relation to seeing a GP,but i have to disagree. You read people moaning about the health center for the last 12 months if not more, and this includes yourself. You asked for change you have got change and in my view for the better. Its people like you that need ti give the new service time to bed in, then the service can be evaluated. Just stop the moaning and give it a chance.

  • ian selbie

    • April 6th, 2015 18:45

    Paul, I take you might be one of the healthy ones about but pray that you don’t get a terminal illness that occasionally requires a quick consultation with a GP and many GPs have like, an ARI consultant never heard about it and the records are too large to read up in a few minutes plus the allergic reactions to many drugs that’s why for my continuity of GP is priority

  • Paul Smith

    • April 12th, 2015 17:22

    Hi Ian
    I have to agree with you in relation to continuity of care. But the need to restructure appointments and service delivery was long over due. Being a patient with a chronic illness myself, we need to give these new practitioners a chance, otherwise there will come a point when you will not be able to get an appointment with anyone, due the the lack of GP and training GPs. There have been advanced nurse practitioners on the islands for many years, ie fair Isle, fetlar, Bressay etc, and these are key to patient safety and well being on the islands. What is interesting to note is when these nurses are on leave and there is no cover, the islanders cause significant up-raw, this just shows how much these nurses are appreciated.


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