Turriff Health Services – Update
I would like to start by thanking all those who attended the meeting held at the Baden Powell Centre in Turriff on 8 August. Thank you also to those who provided contact details for me to provide update of how things have progressed in the last few months since that meeting.
As you will remember, the issues raised fell into three main categories:
• Ambulance cover / waiting times
• Access to minor injury unit
• Turriff Medical Practice / local health services
If you attended the meeting, you will also remember that representatives from Scottish Ambulance Service, Aberdeenshire Health and Social Care Partnership and the Medical Practice were unfortunately unable to attend.
So, since that meeting, I have since engaged further with each of these organisations, as well as with NHS Grampian, and can provide the following update:
Summary of concerns raised:
• Long waits for ambulance to arrive
• Ambulances forced to wait on arrival at Aberdeen Emergency Department
• Shortage of ambulance staff
Turriff has historically experienced some of the longest average waiting times for an ambulance, anywhere in the NHS Grampian area. Along with the rest of the North East, this has been getting progressively worse in recent years – and not just because of Covid-19.
I finally met with the Scottish Ambulance Service on 2 December who, I’m pleased to say,were able to confirm that the stationing of an ambulance in Turriff is currently planned to arrive in March – pending availability of staffing and training.
There are currently two ambulances based in Banff, on 24-hour cover. When there are sufficient staff recruited and trained, one of those ambulances will move to Turriff (at a location still being negotiated), on 16-hour cover.
Crucially, they agreed with me that having more MIUs open – i.e. in Turriff and in Banff – would help reduce the strain at Aberdeen Emergency Department, by providing alternative locations for less serious conditions to present themselves.
It was also noted that several Covid-19 protection measures are still in place, which continue to present a challenge.
Minor Injury Units (MIUs)
Summary of concerns:
• Huntly, Fraserburgh etc. too far away
• Lack of information/awareness of what facilities are available and when
• Surprises for patients presenting themselves to what they believed to be ‘Casualty’, only to be turned away and told to ‘call 111’
• NHS24/111 not familiar system to many residents
The MIU in Turriff was actually remobilised in a limited capacity in early September for three afternoons a week. I’m told that this wasn’t widely publicised in order to avoid the department being flooded with walk ins when there was no minor injury nurse available.
By the end of November, 52 patients had been treated at Turriff MIU including; 5 walk-ins, 34 scheduled (through NHS 24/111) and 13 return/follow-up appointments.
Walk in, urgent care for minor injuries, is technically now possible at Turriff but dependent on a minor injury trained nurse being on duty. Service remains appointment-based via the NHS24/111 triage line, so advice remains to call 111
The current situation is to remain at three afternoons a week with more staff training planned through 2023.
I have also raised directly with NHS Grampian, the need to open MIUs as completely as possible, in order to increase emergency and acute care capacity and relieve pressure on Aberdeen Emergency Department, thereby reducing the bottleneck there that adds to Ambulance waiting times
Turriff Medical Practice
Summary of concerns:
• General lack of access to practice, GPs, etc.
• Unable to book appointments in advance, only able to seek appointment by calling each morning at 08:00am
• Requirement to provide receptionists with confidential details
• Long waits on the phone, can be cut off if waiting too long then at back of queue again
• Reduction in services – such as vaccinations, physiotherapy, chiropody etc.
During the Covid-19 pandemic, the pre-bookable service was removed due to the unpredictability of which clinical staff would be available, due to self-isolation and sickness. When lockdowns across society started to be lifted, the Royal College of GPs noted a 150% increase in demand or primary care appointments.
As well as the increase in demand, I’m told that there have also been challenges in recruitment of GPs, particularly in more rural parts of the NHS Grampian area.
The winter virus season brings high demand from patients who are acutely unwell with respiratory infections. I am told that this appears to be worse than previous years. As a result, I’m told that the current booking system will be maintained for the foreseeable future.
The practice has listened to feedback regarding Covid-19 protection measures and the waiting room has been reopened, although they still have social distancing and PPE wearing as per NHS Scotland guidance.
The phone system is provided by NHS Grampian and, following feedback, the practice has requested the time patients are kept on hold before being disconnected to be extended.
Consulting practices were adapted during the Covid-19 pandemic and, I’m told, have been retained to help practice staff, ‘deal with escalations in demand and to offer options to patients.’
They tell me that they continue to see patients face to face based upon clinical need and that the reception team are trained to support patients navigate the eConsult process if they are having difficulty.
NHS Grampian have also asked me to encourage patients who have any specific complaints about the service provided by any practice, to always raise with the practice directly in the first instance – either in writing to the Health Centre (Turriff Health Centre Balmellie Road Turriff AB53 4DQ) or via the feedback section on their website: www.turriffmedicalpractice.co.uk
On the subject of vaccination centres (not just for Covid-19), Turriff Medical Practice informed me that The Scottish General Medical Services Contract 2018 led to changes in health care provision such as transferring the responsibility for vaccinations and treatment room nursing services from general practice to Health and Social Care Partnerships. These services have been established outwith general practice across the NHS Grampian area and local provision at Turriff Hospital and Macduff Vaccination Centre are managed by Aberdeenshire Health and Social Care Partnership.
Travel vaccinations are now delivered by Community Pharmacies.
Secondary care blood hubs were established post-pandemic and perform tests and investigations requested by hospital consultants. The Practice tell me there is now a local secondary care hub at Turriff Hospital.
NHS Grampian is responsible for Allied Health Care Professionals such as Physiotherapists, Occupational Therapists and Chiropodists. Turriff Medical Practice has no influence or involvement or the recruitment, backfill or training of this staff group.
External services for mental health and counselling manage their own appointment bookings / waiting times. The practice tells me that they try to expedite referrals if necessary but secondary care referral criteria is mandated for them to follow.
Finally, on the subject of patients’ concerns in dealing with receptionists with matters of a confidential nature, I am assured that receptionists are bound by the same confidentiality rules as clinical staff.
Practice receptionists are the first contact in the clinical process and it is a key part of their role to gather information to allow signposting to external services or on behalf of the supervising clinician.
I will continue to review all the above and am seeking further clarification on some of the outstanding issues.
I am also considering a further public forum in the future, possibly in a different ‘drop-in’ type format.
David Duguid MP
Banff and Buchan