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