Westlake critical of ‘dysfunctional’ GP clinic system

A Lerwick councillor has demanded answers from NHS Shetland, saying she and fellow residents are angered and frustrated at a lack of available doctors’ appointments at the “dysfunctional” Lerwick Health Centre.

Amanda Westlake has written a letter to NHS Shetland about the managment of the town practice, calling for a solution from the board for the lack of doctors and lengthy waiting times.

In the letter, which she shared with this newspaper, Ms Westlake said: “I wish to make clear at the outset that I am in no way criticising the staff at LHC [Lerwick Health Centre] who are doing their best in very difficult working conditions, but I feel strongly that senior health board management must provide answers in order to rectify the ongoing, and worsening, management system at the health centre.

“I can recall that two years ago during meeting of SIC Social Services Committee councillors were advised that the Lerwick practice was three doctors short but were assured that the matter would be resolved. Two years on and it has not been.

“The laudable attempt to use advanced nurse practitioners to help screen and prioritise appointments is useful but the system fails when they decide that the patient must see a doctor and they cannot deliver on that commitment.”

Ms Westlake said she has been contacted by a number of patients who have had to wait weeks to see a GP after seeing a nurse and was also told a family member would have to wait seven weeks for a GP appointment. She includes some of their difficulties in the letter.

She said: “In my own case I phoned for an appointment on behalf of an elderly family member who has long-term medical conditions and was clearly not well, only to be told that there would be no appointment for seven weeks.

“I was advised to book with a nurse practitioner but considered this inappropriate as this was an ongoing medical condition which should not need re-assessment. It is extremely worrying to realise that with an increasingly ageing population it is elderly people who are the bulk of patients having to wait weeks for a GP appointment, and they are the ones who are least likely to complain.

“The board should realise that this lack of complaint provides a false picture of patient satisfaction. I can assure you however, that I have been inundated with responses on social media.”

She added: “It must be glaringly obvious to you from the above telling examples that Lerwick Health Centre is a dysfunctional organisation which is struggling and failing to meet the needs of its Lerwick patients due, in large part, to the shortage of doctors,” she said.

“The consequent effect is that all aspects of the service is under stress, resulting in recurring instances of poor communication, concerns about medication and treatment, delays and poor communication between GP staff and patient, delays in follow-up appointments particularly with regard to patient transfer back to Shetland.

“Communication is so bad that it takes about three weeks to send a referral for an appointment across the road to the physiotherapy department in the Gilbert Bain Hospital.

“In conclusion I trust that I on behalf of all Lerwick patients, will receive your assurance that these issues will receive your urgent attention.

“You cannot be unaware that they exist.”

Chairman of the Shetland Public Partnerhsip Forum (PPF), which conducted a survey among patients at the health centre in 2013, this week defended the health centre’s record and said improvements had been made. However, he conceded that a shortage of doctors was an issue, as it is across the country.

About 900 people responded to the survey with 78 per cent saying they were unhappy with the appointment system in use at the time.

PPF chairman Harold Massie said that the survey had “a superb response” and doctors came up with the proposal of using ANPs as the first line of service for patients.

“That has worked well,” said Mr Massie with patients being able to see a nurse within 24 hours.

He said there was a GP on hand at the health centre when ANP clinics were being held.

The nurses had the patients notes before them and had guidelines to follow during consultations, he said.

If matters fell outwith the guidelines of complaints the can deal with the nurses contacted the GP.

“Eighty five per cent of the consultations are handled by an ANP with only a small need to call the doctor,” Mr Massie said.

“The problem comes when doctors have to do follow-ups; there’s just not enough [doctors]. This is a national problem… there’s just a national shortage of doctors.”

• For more see this week’s edition of The Shetland Times



Add Your Comment
  • Magnus Johnson

    • August 12th, 2016 18:23

    Hard to tak dis persons complaint seriously as it just comes across sounding like ‘ooh im a cooncillor and i just had a bad service experience so im goin to wield my mighty power and send a letter to complain aboot it, behold my power in aa its glory!.’ If the problem has persisted for over twa years yer only kicking up a fuss noo cos du didnt get da 5 star treatment a powerful overlord of your stature deserves. Course people bitched on social media its lot easier to sit on dee erse and type a comment than to actually lodge official well thought out complaints.

    Its fairly simple there’s no enough doctors, they cant force doctors to come here and maybe the doctors that do consider it check oot da local papers and see a pleepsy councillor spouting aff fir issues everyone using da service encounters fae john o groats to lands end.

  • Paul Smith

    • August 12th, 2016 18:40

    The comments in this article are of interest especially the one surrounding long term condition management. The nurse practitioners are highly trained and are able to manage long term conditions without input from the GPs. The impression i get is that Ms Westlake, does not actual understand the role and scope of these nurses. Nurse practitioners work across the islands for example Bressay, Fair Isle, Skerries, Foula and Fetla for many years and there scope of practice is just the same. So rather than waiting and complaining about not getting to see a GP take the nurse practitioner appointment, you may actually be surprised.

  • ian tinkler

    • August 12th, 2016 21:43

    Nine years of devolved NHS to the SNP/SG. The election bribe of free prescriptions is not much good when you cannot see a General Practitioner or NHS Dentist. Well done SNP, no more need be said.

  • David Spence

    • August 13th, 2016 16:18

    I have recently visited the Lerwick Health Centre, where I had an appointment to see the nurse. All I can say is the service I received was first class, the nurse very understanding, helpful and compassionate.

    Yes, everybody gripes about the health clinic or the nhs, but I am pretty sure if those people had to pay extortionate fee’s and have drastically lower standards of service, then they may think twice about lambasting the nhs.

    When profits replace health and the service you get, then you can justifiably complain.

  • Alison Moncrieff

    • August 13th, 2016 16:45

    Given that the doctors have asked the same question of Tavish, to be given the brush off, the more counsellors (or anyone) who can kick up a fuss and get things changed the better (Magnus J).
    The situation is NOT nationwide, if I phone my doctor I can get an emergency appointment the same day, emergency being something which requires urgent attention but is not severe enough to go to a&e.
    Maybe a petition to the health board….or even the health Secretary #thinkingoutloud

  • Paul smith

    • August 14th, 2016 22:50

    I am afraid Alison, you have four facts wrong. Remote and rural GP shortage is a significant problem locally as well as nationally. ( try googling it ) There is a shortage of GP trainees which then has a knock on effect on supply and demand across the health service. You may be able to get an emergency appointment from other GP services out with Shetland, but like I say they are not classed as remote and rural settings, hence usually there is more of them.

    No matter how hard you put your weight as the “face of the community” behind campaigners this will not solve the problem of GPS not wanting to specialise in remote and rural setting, and to be fair why would you want to come somewhere where the local councillors are always on your back. I certainly would not.


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