Update from Stronsay Community Council
Republished here with kind permission of The Stronsay Limpet.
As many of you will have become aware, there has been a proposed plan to implement NHS24 (111) across the 10 ferry linked islands of NHS Orkney, originally effective from 5/12/2022 (this would initially be for the winter period to end of February and then be reviewed).
This decision had been made by the NHS Orkney Board, with no prior consultation with island clinicians or community councils. The isles clinicians were informed of this decision at a meeting at the beginning of November. Our island GP’s were collectively unhappy with these proposals and involved the community council. Similar feelings were shared on all the other affected isles, and a joint (remote) meeting was convened on 7/11/22 where all 10 community councils were represented by chairs and vicechairs, as well as the 3 north isles councillors. After the initial presentation of their proposals, there were many questions posed by those present, mainly addressing their concerns around the idea.
Following this meeting, the north isles councillors thought it a good idea to convene a meeting of the community councils (without the NHS persons present) to discuss a response to this. The response to that meeting was that an open letter, addressing all our concerns, be sent to the members of the NHS Board. That letter is attached to this article.
As a result of this letter, there was another meeting held last week, again with all community councils being represented. At this meeting, the NHS board members expressed their surprise over the level of concerns, but agreed they needed to address them. Therefore, a decision was made to postpone the decision to implement NHS24 until such time as they could speak to all the isles clinicians, a process they expected would take about 3 weeks, at which time a further meeting would be convened to discuss the matter further. Once this happens, we can provide the community with a further update.
During all these meetings, we were all reminded that in the cases of an extreme (life threatening) emergency, we should always bypass usual protocol and dial 999.
Finally, I would like to make you all aware that we have Stephen Brown from the NHS Board, attending the beginning of our community council meeting next week, Monday 5th December, at 7pm, in the community hall. If anyone has any questions they wish to put to him, you are welcome to attend for this or please feel free to contact any of the community council members to put the question for you.
On behalf of the community council
Categories: Local News
NHS Orkney might not care about the risks to patients, but they might be able to see that their proposed approach is short-sighted and anticipated savings could be offset – or even outweighed – by creating extra costs: for individuals, society, taxpayers, the economy and the wider public.
Just looking at strokes as an example for when time is critical:
‘People who have had a stroke need access to high quality acute care as quickly as possible…. which improves their outcomes’ (https://www.nice.org.uk/media/default/about/what-we-do/into-practice/measuring-uptake/nice-impact-stroke.pdf).
Stroke is associated with high costs to society: ‘…stroke can reduce employment prospects and productivity for society. It can also affect family and friends who are often involved with a stroke survivor’s care and are unpaid in this caring role. This is even more concerning given current and likely ongoing financial pressures on health and social care services, families and other unpaid carers’ (https://www.stroke.org.uk/sites/default/files/costs_of_stroke_in_the_uk_report_-executive_summary_part_2.pdf).
Mitigation of such damages – including the wider societal and financial burden – depends upon speedy access to the right treatment without undue delays: ‘Healthcare systems should develop maximal effort to shorten pre-hospital and in-hospital delays in acute stroke patients. The earlier the patient is presenting, the more important is the fast track, offering chance for full neurologic recovery’ (https://www.sciencedirect.com/science/article/pii/S0010865016300170).
The situation is similar for other conditions where the outcome depends on time-critical access to care.
NHS Orkney’s proposed plans are unlikely to be financially viable. Whilst they would re-distribute financial burdens to a certain extent to be shared with the wider society (instead of NHS Orkney), they would not reduce such burden overall; in fact the financial burden would even increase, given the complexity of additional and lengthy (as well as costly!) interventions needed as a possible result of avoidable delays.
Last, but not least: Island frontline staff would face the brunt of responsibility, simply through the fact that they might only be notified with delay, therefore cannot act quickly enough to prevent dismal outcomes in cases where this would have been preventable. It is anyone’s guess whether this attracts GPs to work in the isles.
If the NHS Orkney is so desperate to make savings, perhaps they should start with eradicating unnecessary administration and bureaucracy. Why are letters sent out to confirm appointments when these appointments have been arranged over the phone by the patients themselves, why can’t patients arrange repeat prescriptions themselves with pharmacies (in England they can) and so forth. There is a potential to increase efficiency in routine and administrative processes. This potential should be used when budgets are tight. Risking patients’ health and lives is not acceptable only because management is lacking the required skills.