NHS Highland yesterday approved controversial plans to reduce out-of-hours GP provision in five north communities.
Board chairman David Alston said the move was necessary for a more sustainable model of care, with chronic staff shortages and spiralling locum costs affecting the most rural parts.
Under the plans, the current doctor-led service would be replaced with one where advanced nurse practitioners and paramedics would respond in more cases.
It means new nursing staff will have to be recruited and based at Inverness, Thurso, Golspie, Aviemore , Wester Ross, West Sutherland and Ardnamurchan.
But there will no longer be locally-based out-of-hours GP cover in Lochaline in Morvern, Glenelg and Arnisdale in Lochalsh, Applecross in Wester Ross, and Lochinver, Armadale and Tongue in Sutherland.
And yesterday residents from Glenelg and Arnisdale – whose out-of-hours cover may be moved to Broadford – attended the board meeting in Inverness.
Afterwards Peter Jones, of Glenelg, said that although he was reassured over some points after the meeting, he remained “concerned” about the possibility of having no locally-based health professional.
He added: “We think it would be absolutely unsafe for us to rely on Broadford.
“In an emergency, if the information is given to the ambulance service by a non-professional there is obviously room for mistakes to be made, and I say that in the best of faith”.
The Scottish Government is providing funding to enable testing of the changes, in line with recommendations made in a national report by Sir Lewis Ritchie.
Yetserday a team of NHS staff – GP Antonia Reed, statistician Evan Beswick and north and west Highland operations director Gill McVicar – presented details of how they plan to “transform urgent care” in the north.
Mrs McVicar said there will need to be investment in training for more nurse practitioners and that the emphasis should be on “growing our own” to ensure that they stay.
She added that more days of training will be given to local first responders to build community resilience, and that retained firefighters would play a bigger role.
Following the meeting, board chairman David Alston said: “It’s not a sustainable system at the moment and we need to change quickly for the wellbeing of these communities.
“It’s over 10 years since GPs no longer had responsibility for out-of-hours cover, and I don’t think we moved quickly enough to new systems and I think it would have been better for communities if we had been bolder in the past”.
