NHS Fife suggests (today’s Courier) that recent soaring A&E attendances at the Victoria Hospital may be due to Scotland’s new GP contract allowing GPs to opt out of providing out-of hours services. Yet contracts allowing them to opt out have been in force since 2004.
In fact, the latest contract, which was agreed last year, was specifically adapted to attract more GPs by including a new enhanced opt-in for GP practices.
The doors were locked on out-of-hours services between midnight and 8am at centres in Glenrothes, Dunfermline and St. Andrews in April 2018. Since then more Fifers have called 999 or gone to A&E at Kirkcaldy when they have been taken ill during these hours. The connection is obvious.
The Fife Health & Social Care Partnership has consistently maintained that there is no evidence that partially shutting these three services has damaged patient care and safety, or that a proposed total closure of the out-of-hours services at St Andrews and Glenrothes would do so. Reports from individuals to the contrary have been dismissed as anecdotal.
Had clear statistics been published, showing the effect of partial closures on First Responder and ambulance call-outs and response times, and on A&E admissions and waiting times, the controversy about the Fife-wide out-of-hours service could have been settled many months ago.
At the very least, simply continuing the contingency arrangements, under which the three local centres are set to remain closed from midnight to 8am until December 2019, would have been indefensible.
Instead, what remains of the Fife out-of-hours service is being run down, as GPs who used to work from midnight to 8am go elsewhere and the morale of those who remain nosedives.