Out-of-hours service under 'immense pressure' (From Malvern Gazette)

Out-of-hours service under 'immense pressure'

9:20am Monday 7th January 2013 in News By James Connell

Out-of-hours service under 'immense pressure'

AN OUT-of-hours service is under immense pressure as doctors deal with well over double the average number of patient calls in Worcestershire this winter.

However, Dr Jonathan Leach, medical director for NHS Worcestershire, says he has ‘confidence’ in the service being offered by the private company which runs the £5.4 million a year contract.

Harmoni normally gets around 50 calls per hour but an unannounced visit by Dr Leach on the Saturday before Christmas revealed 120 calls an hour (900 calls a day compared to a predicted 600-700).

The service provides care to people who cannot see their GPs at weekends and evenings when many surgeries are closed following changes in 2004 which allowed GPs to opt out of working these shifts.

Reports in the national media have suggested out of hours providers have been under increasing pressure because of the high volume of patients and concerns have been raised about the safety of the service.

However, Dr Jonathan Leach, said he had ‘confidence’ in Harmoni which has a £5.4 million a year contract with NHS Worcestershire.

NHS Worcestershire has given Harmoni extra money to help them respond to patients needs more quickly, so they can see patients within four hours instead of the national contract minimum standard of six hours.

Dr Leach said: “It’s fair to say that the whole system is under very considerable pressure at the moment. The acute trust is struggling but we’re no different from anyone else.”

The national press has made reference to ‘mayday messages’ being sent out to doctors to work last minute shifts but Dr Leach said this phrase was too ‘emotional’. He said messages were sent out via text and email asking doctors if they could help fill shifts.

He said: “There is a game some of the doctors and nurses play because they know, if they wait long enough, they will be paid a premium to come in.”

Dr Leach said the system was very closely scrutinised and during his unannounced visit there were 16 doctors available out of hours across the county. Dr Leach said the number of doctors working out of hours shifts depended on the predicted workload. Of those 16 doctors, 10 were based at various hospitals and out of hours centres across the county such as Worcestershire Royal Hospital, Evesham Community Hospital, the Alexandra Hospital in Redditch and Kidderminster Hospital and six were in cars performing home visits.

Dr Leach said because out of hours was based in the same building as A&E at Worcester which has been under considerable pressure they had offered to put more doctors on to manage the demand.

Dr Leach said: “The relationship with Harmoni is good but, yes, they’re under pressure and we monitor them. We’re doing a huge amount but it is difficult at the moment. We’re doing ever we can.”

Formal meetings are held between NHS Worcestershire and Harmoni every month to discuss clinical issues, response times and complaints although Dr Leach said there were ‘very few’ complaints.

Talks are underway to expand the number of shifts which involve GPs travelling with paramedics to 999 calls to reduce pressure on hospitals and the need for admission.