Out-of-hours fears for rural patients

Oct 2 2007 by Audrey Barton, The Journal

A NORTH MP voiced renewed concerns last night about rural patients’ access to out-of-hours healthcare as a review is launched into the effectiveness of the service.

Berwick MP Alan Beith said the poor handling of the contract three years ago has cost the government around £1.8bn more than estimated.

He has raised concerns over access to out-of-hours doctors in rural areas such as Northumberland. A review of the service is under way by NHS North of Tyne three years after its inception but health bosses have said it is ‘informal’.

The body which runs out-of-hours care in the county last night said it has exceeded all its targets in responding to patients and that each is treated according to their clinical need no matter where they live.

But Mr Beith said: “Not only are taxpayers paying huge prices but in rural areas like Northumberland we have had to accept much reduced availability of doctors out-of-hours.

“I remain worried particularly about the situation where the only doctor on duty after midnight may be on Tyneside when he is needed in Berwick or Alnwick.”

Northern Doctors Urgent Care took over the out-of-hours service after reforms in 2004 which allowed family doctors to stop working late hours in exchange for a £6,000 pay cut.

Mr Beith said the Northumberland service had been made “extremely difficult and much more expensive” as a result of the government reforms.

He does believe the service has improved at the urgent care centres across the patch with more local GPs taking shifts. But Mr Beith added: “I remain concerned that after midnight the only available doctor might be in Tyneside when the patient could be in Berwick. In effect it is so much easier to send for an ambulance.”

John Harrison, general manager of NDUC which covers North and South Tyneside and Northumberland said urgent centres including those in Alnwick and Berwick are closed between midnight and 8.30am.

Doctors respond to calls made to the Gosforth call centre in cars across the patch. He said: “The standards that we apply are the same for rural and urban areas. The doctor assesses what the most appropriate care is for the patient. All cases are treated solely on their clinical need. We don’t treat them any differently because of where they are.”

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Performance targets

NORTHERN Doctors Urgent Care’s performance against targets set by the Government for 2006:

98% of calls answered within 60 seconds against a target of 95%.

97.9% of urgent clinical triage, classifying patients according to their needs, took place within 20 minutes against a target of 95%.

98% of urgent face-to-face consultations took place within two hours – an average of 18 minutes for centre visits and 53 minutes for home visits – against 95%.

99.3% of routine clinical triage took place within 60 minutes.

99.6% of routine face-to-face consultations took place within six hours – an average of 18 minutes for centre visits and 106 minutes for home visits – against target of 95%.

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We treat obese patients - trust

A COUNTY Durham NHS trust accused of restricting surgery for obese patients by an ITV investigation has denied the allegation, blaming an error in its response.

The Tonight With Trevor McDonald television programme last night monday said one in 10 NHS trusts of the 152 in England have policies restricting non-emergency surgery such as hip replacements because of patients’ lifestyles.

County Durham PCT is named as one of the 16 trusts which apply restrictions to obese patients or those who smoke.

The North-East has the highest obesity levels in the country with one in four adults in the region currently classed as obese.

The Tonight programme, Too Fat For Treatment, examined whether patients are being barred from operations on medical grounds or as a cost-cutting exercise.

But the County Durham trust has denied any ‘overarching policy’ which ‘precludes’ surgical treatment because of lifestyle choices.

The PCT refused to provide The Journal with its original response to the television programme on August 1 as it was “incorrect”.